1922332675 NPI number — VALORI RICHARDSON T-LPC

Table of content: VALORI RICHARDSON T-LPC (NPI 1922332675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922332675 NPI number — VALORI RICHARDSON T-LPC

Organization/Personal Information

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

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1922332675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 550
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERTON
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66770-0550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-848-2300
Provider Business Mailing Address Fax Number:
620-848-2301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6610 SE QUAKERVALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66770-4185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-848-2300
Provider Business Practice Location Address Fax Number:
620-848-2301
Provider Enumeration Date:
09/29/2009

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:  2117 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100098150A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".