Provider Demographics
NPI:1073722153
Name:HARRIS-RICHARDS, DONNA MARIA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIA
Last Name:HARRIS-RICHARDS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5325
Mailing Address - Country:US
Mailing Address - Phone:508-990-9909
Mailing Address - Fax:508-990-2732
Practice Address - Street 1:103 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5325
Practice Address - Country:US
Practice Address - Phone:508-990-9909
Practice Address - Fax:508-990-2732
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1155381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA212395OtherLICENSE NUMBER