Provider Demographics
NPI:1457627036
Name:ROBIN RICHARDSON
Entity Type:Organization
Organization Name:ROBIN RICHARDSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-621-2214
Mailing Address - Street 1:144 N DITHRIDGE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2659
Mailing Address - Country:US
Mailing Address - Phone:217-621-2214
Mailing Address - Fax:412-246-5300
Practice Address - Street 1:144 N DITHRIDGE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2659
Practice Address - Country:US
Practice Address - Phone:217-621-2214
Practice Address - Fax:412-246-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty