Provider Demographics
NPI:1316373988
Name:RICHARDSON, ANNIE HUNT (PSYD)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:HUNT
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:DOLLE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 856
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-0856
Mailing Address - Country:US
Mailing Address - Phone:720-446-8408
Mailing Address - Fax:
Practice Address - Street 1:275 CENTURY CIR STE 203
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9453
Practice Address - Country:US
Practice Address - Phone:720-446-8408
Practice Address - Fax:303-499-2635
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.5627103TC0700X, 103TC0700X
COPSY.0005627103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000201565Medicaid