Provider Demographics
NPI:1679276042
Name:RICHARDT, SHARON LOUISE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LOUISE
Last Name:RICHARDT
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-2816
Mailing Address - Country:US
Mailing Address - Phone:845-321-2434
Mailing Address - Fax:
Practice Address - Street 1:17 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-2816
Practice Address - Country:US
Practice Address - Phone:845-321-2432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-10-6727103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst