Provider Demographics
NPI:1659816619
Name:RICHARDSON, LAURA BETH (BSW)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:BETH
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-6105
Mailing Address - Country:US
Mailing Address - Phone:606-772-1030
Mailing Address - Fax:606-451-0558
Practice Address - Street 1:4341 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-6105
Practice Address - Country:US
Practice Address - Phone:606-772-1030
Practice Address - Fax:606-451-0558
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker