Carlos De'Wayne Richardson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3843 Issued in AL

Practice address

100 Century Park S Ste 102
Birmingham, AL 35226-3922

Phone

(205) 565-6554

Fax

(888) 386-9624

NPI assigned

Sep 11, 2017

Last updated

Jan 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama Foundation of Therapeutic Services, Inc

  • Professional Counselor
  • Birmingham, AL
  • NPI 1518466176
  Authorized official Same address or phone

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1083133003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTURY PARK S STE 102",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352263922",
            "telephone_number": "205-565-6554",
            "fax_number": "888-386-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY PARK S STE 102",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352263922",
            "telephone_number": "205-565-6554",
            "fax_number": "888-386-9624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 Mayfair Ln",
            "address_purpose": "LOCATION",
            "city": "Calera",
            "state": "AL",
            "postal_code": "350405598",
            "country_code": "US",
            "telephone_number": "205-306-2866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4204 Edmonton Dr",
            "address_purpose": "LOCATION",
            "city": "Bessemer",
            "state": "AL",
            "postal_code": "350224878",
            "country_code": "US",
            "telephone_number": "205-425-1200 x4353",
            "fax_number": "205-425-9606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CARLOS",
        "middle_name": "DE'WAYNE",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "C2131A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "3843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richardson Rehabilitation Services, PC
• Richardson-Mintzcounseling Center
• Alzelda Richardson, PH.D.
• Brock Richardson, MD
• Caleb Daniel Richardson, CRNA
• Claire Richardson
• Colin Joseph Richardson
• Devona Richardson
• Dexter Richardson, RBT
• Elizabeth Joy Richardson, PHD

• Professional Counselor in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.