Provider Demographics
NPI:1487689931
Name:RICHARDS, ANGELYN COOMBS (MED LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELYN
Middle Name:COOMBS
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MED LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 CAPITAL CIRCLE N.E.
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3723
Mailing Address - Country:US
Mailing Address - Phone:850-570-0073
Mailing Address - Fax:850-562-9484
Practice Address - Street 1:5382 PEDRICK CROSSING DR.
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32317-2198
Practice Address - Country:US
Practice Address - Phone:850-570-0073
Practice Address - Fax:850-562-9489
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9349OtherBCBS