Provider Demographics
NPI:1154075539
Name:RICHARDSON PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:RICHARDSON PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-404-8646
Mailing Address - Street 1:7207 BLUEBILL ST
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:MI
Mailing Address - Zip Code:48001-4105
Mailing Address - Country:US
Mailing Address - Phone:810-488-1202
Mailing Address - Fax:
Practice Address - Street 1:632 N MILL ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1422
Practice Address - Country:US
Practice Address - Phone:734-404-8646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty