Provider Demographics
NPI:1790114346
Name:RICHMOND, COURTNEY MEGAN (MS, CAS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MEGAN
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MS, CAS
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MEGAN
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1026 HARVARD ST NW
Mailing Address - Street 2:APT 2
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1026 HARVARD ST NW
Practice Address - Street 2:APT 2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3910
Practice Address - Country:US
Practice Address - Phone:607-341-3643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool