Individual
NICOLE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
16601 N 40TH ST STE 216, PHOENIX, AZ 85032-3354
(480) 788-8466
Mailing address
16601 N 40TH ST STE 216, PHOENIX, AZ 85032-3354
(480) 788-8466
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-23662
AZ
Other
Enumeration date
09/15/2025
Last updated
10/24/2025
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