Provider Demographics
NPI:1437317278
Name:RICHARDSON, UGANDA TUNISIA (BSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:UGANDA
Middle Name:TUNISIA
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:BSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1782 N. TURNER ST
Mailing Address - Street 2:1020
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240
Mailing Address - Country:US
Mailing Address - Phone:405-204-7813
Mailing Address - Fax:
Practice Address - Street 1:3012 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1424
Practice Address - Country:US
Practice Address - Phone:405-204-7813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49971041C0700X
OR125771041C0700X
NMSWB-2022-07131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR$$$$$$$$$Medicaid
OR$$$$$$$$$OtherPRIVATE INSURANCE
NM$$$$$$$$$OtherNEW MEXICO PRIVATE INSURANCE
OK$$$$$$$$$OtherPRIVATE INSURANCE