Provider Demographics
NPI:1205139458
Name:RICHARDSON, CATHERINE ELIZABETH (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 WAGNER RD
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-6622
Mailing Address - Country:US
Mailing Address - Phone:518-372-7946
Mailing Address - Fax:518-207-1907
Practice Address - Street 1:1 PINNACLE PL
Practice Address - Street 2:SUITE 102
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3496
Practice Address - Country:US
Practice Address - Phone:518-689-0244
Practice Address - Fax:518-207-1907
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073496101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health