Provider Demographics
NPI:1033697842
Name:RICHARDSON, SPRING (LPC)
Entity Type:Individual
Prefix:
First Name:SPRING
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-213 HOAKEA PL
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-5570
Mailing Address - Country:US
Mailing Address - Phone:205-276-4363
Mailing Address - Fax:
Practice Address - Street 1:95-213 HOAKEA PL
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-5570
Practice Address - Country:US
Practice Address - Phone:205-276-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC515101Y00000X
DCPRC14414101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor