Individual provider Active NPI

Ivanna M Richardson, EDD LMFT LPC

  • Counselor
  • Elm Grove, WI
National Provider Identifier
1003904947
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1685125 Issued in WI
Practice address
12970 W Bluemound Rd
#105
Elm Grove, WI 53122
Phone
(262) 787-2907
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1685125 WI Primary
Marriage & Family Therapist 106H00000X 493124 WI

Addresses

Primary practice location

12970 W Bluemound Rd
#105
Elm Grove, WI 53122

Mailing address

12970 W Bluemound Rd
#105
Elm Grove, WI 53122
Phone (262) 787-2907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1685125WIMDCounselor
493124WIMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1003904947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12970 W BLUEMOUND RD",
            "address_2": "#105",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "53122",
            "telephone_number": "262-787-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12970 W BLUEMOUND RD",
            "address_2": "#105",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "53122",
            "telephone_number": "262-787-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "IVANNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "EDD LMFT LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "1685125",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "493124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elm Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.