Individual
MS. RITA JEAN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED LPCMHSP
Contact information
Practice address
218 N MAIN AVE, ERWIN, TN 37650
(423) 743-1470
(423) 743-1472
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC1721
—
101YP2500X
Professional Counselor
Primary
1721
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010150132
—
VA
01
—
351654200
DOL WORKERS COMP
—
01
—
4098444
MAGELLAN SUMMIT
—
01
—
620582605
THREE RIVERS PROVI GROUP
—
Enumeration date
09/12/2006
Last updated
10/11/2019
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