Provider Demographics
NPI:1568451060
Name:RICHARDSON, JOYCE ANN (MSW LCSWR)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:MSW LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-7443
Mailing Address - Country:US
Mailing Address - Phone:315-336-1170
Mailing Address - Fax:
Practice Address - Street 1:5 THOMAS DR
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-7443
Practice Address - Country:US
Practice Address - Phone:315-336-1170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0395711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical