1245674100 NPI number — CATHERINE RICHARDSON LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245674100 NPI number — CATHERINE RICHARDSON LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARDSON
Provider First Name:
CATHERINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EVANS
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245674100
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1602 SEQUOIA DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KRUM
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76249
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-220-9469
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8300 US HIGHWAY 380
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
CROSS ROADS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-220-9469
Provider Business Practice Location Address Fax Number:
972-426-9609
Provider Enumeration Date:
04/23/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  70653 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 76053 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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