Provider Demographics
NPI:1801691738
Name:RICHARDSON, CHARLOTTA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 SAGE MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6871
Mailing Address - Country:US
Mailing Address - Phone:414-530-2828
Mailing Address - Fax:
Practice Address - Street 1:8668 JOHN HICKMAN PKWY STE 1001
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9388
Practice Address - Country:US
Practice Address - Phone:469-664-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist