Provider Demographics
NPI:1114493822
Name:RICHARDS, TODD LINCOLN (CADC-1)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:LINCOLN
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:CADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5166 GAVIOTA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1429
Mailing Address - Country:US
Mailing Address - Phone:310-621-0686
Mailing Address - Fax:
Practice Address - Street 1:11027 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2431
Practice Address - Country:US
Practice Address - Phone:818-985-8323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)