Individual
KELLY NICOLE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
6707 WHITESTONE RD, GWYNN OAK, MD 21207-4106
(410) 265-8737
(410) 265-1258
Mailing address
6707 WHITESTONE RD, GWYNN OAK, MD 21207-4106
(410) 265-8737
(410) 265-1258
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
17243
MD
104100000X
Social Worker
781387
MD
Other
Enumeration date
12/05/2014
Last updated
04/30/2019
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