Provider Demographics
NPI:1497460885
Name:UGANDA RICHARDSON LCSW LLC
Entity Type:Organization
Organization Name:UGANDA RICHARDSON LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:UGANDA
Authorized Official - Middle Name:TUNISIA
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-204-7813
Mailing Address - Street 1:1781 N TURNER ST # 1020
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-3801
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty