Provider Demographics
NPI:1225678832
Name:RICHARDSON, JOHN ANTHONY (LMHC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-7336
Mailing Address - Country:US
Mailing Address - Phone:812-214-4422
Mailing Address - Fax:
Practice Address - Street 1:2990 N STATE HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-7189
Practice Address - Country:US
Practice Address - Phone:812-346-7744
Practice Address - Fax:812-346-3815
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-11
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004128A101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health