Provider Demographics
NPI:1881002806
Name:RICHARDSON, SHARI (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 WILLIS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-8036
Mailing Address - Country:US
Mailing Address - Phone:347-731-2583
Mailing Address - Fax:516-385-3586
Practice Address - Street 1:674 WILLIS ST
Practice Address - Street 2:
Practice Address - City:SOUTH HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-8036
Practice Address - Country:US
Practice Address - Phone:347-731-2583
Practice Address - Fax:516-385-3586
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0821211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical