Provider Demographics
NPI:1013077577
Name:RICHARDS, SUE CAROL (SW, PSC)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:CAROL
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:SW, PSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 KLUTEY PARK PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-3348
Mailing Address - Country:US
Mailing Address - Phone:270-826-3951
Mailing Address - Fax:270-827-5527
Practice Address - Street 1:472 KLUTEY PARK PLAZA DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-3348
Practice Address - Country:US
Practice Address - Phone:270-826-3951
Practice Address - Fax:270-827-5527
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator