Richardson, Phyllis J.
Richardson, Phyllis J. is an individual health care provider with primary practice located at 2336 Goddard Pkwy Eastern Shore Psychological Services, Salisbury MD 21801-1126. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Richardson, Phyllis J. can be contacted via phone (410) 334-6961.Contact Information
Primary practice address
2336 Goddard Pkwy Eastern Shore Psychological Services
Salisbury MD 21801-1126
Phone: (410) 334-6961
Fax: (410) 334-6362
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ACO251 | Maryland |
Profile Details
| NPI number | 1730244898 |
|---|---|
| LBN Legal business name | Richardson, Phyllis J. |
| Credentials | CAC-AD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Aug 30th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730244898 | NPPES |
| Maryland | MEDICAID | 1093074064 | |
| Maryland | MEDICAID | 705371101 |
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