Provider Demographics
NPI:1275866469
Name:RICHARDSON, BELINDA (PH,D)
Entity Type:Individual
Prefix:DR
First Name:BELINDA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8930 FOURWINDS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1970
Mailing Address - Country:US
Mailing Address - Phone:210-778-8256
Mailing Address - Fax:800-934-2059
Practice Address - Street 1:8930 FOURWINDS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1970
Practice Address - Country:US
Practice Address - Phone:210-778-8256
Practice Address - Fax:800-934-2059
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-07
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200860106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282036701Medicaid