Provider Demographics
NPI:1609930429
Name:RICHBERG, DORINDA ANGELA GAYNELLE (LMHC NCC)
Entity type:Individual
Prefix:MRS
First Name:DORINDA
Middle Name:ANGELA GAYNELLE
Last Name:RICHBERG
Suffix:
Gender:F
Credentials:LMHC NCC
Other - Prefix:
Other - First Name:DORINDA
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC NCC
Mailing Address - Street 1:63 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704
Mailing Address - Country:US
Mailing Address - Phone:917-478-3914
Mailing Address - Fax:
Practice Address - Street 1:63 COURT STREET
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704
Practice Address - Country:US
Practice Address - Phone:917-478-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY004735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program