Provider Demographics
NPI:1295530103
Name:RICHMOND PSYCHOTHERAPY, LCSW P.C.
Entity type:Organization
Organization Name:RICHMOND PSYCHOTHERAPY, LCSW P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-584-4798
Mailing Address - Street 1:38 WINTHROP PL STE I
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3043
Mailing Address - Country:US
Mailing Address - Phone:718-727-7077
Mailing Address - Fax:718-667-3260
Practice Address - Street 1:38 WINTHROP PL STE I
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3043
Practice Address - Country:US
Practice Address - Phone:718-727-7077
Practice Address - Fax:718-667-3260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty