Provider Demographics
NPI:1225189061
Name:RICHARDS, MARY ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:KOHLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:48 VANDERVEER DR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3746
Mailing Address - Country:US
Mailing Address - Phone:908-771-0100
Mailing Address - Fax:908-771-0100
Practice Address - Street 1:133 GALES DR
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-2903
Practice Address - Country:US
Practice Address - Phone:908-771-0100
Practice Address - Fax:908-771-0100
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052282001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical