Jacquetta S Richardson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

25947 Issued in MD

Practice address

5820 York Rd
Baltimore, MD 21212-3610

Phone

(301) 345-1022

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Transition and Transform, LLC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1922939826
  NPD Authorized official
• Advanced Behavioral Health, Inc

  dba ABH, Inc.

  • Clinic/Center
  • Frederick, MD
  • NPI 1154799559

  DC

  Medicare reassignment
• Advanced Behavioral Health, Inc

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1164244471
  NPD

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1194342824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123610",
            "telephone_number": "301-345-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 YORK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123610",
            "telephone_number": "301-345-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JACQUETTA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "25947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jane Richardson, M.D.
• Erika Latarsha Richardson, RRT
• Erin J Richardson, LCPC - S
• Frank Richardson Jr.
• Fredricka Richardson, RN
• James Paul Richardson, M.D., M.P.H.
• Jeffrey Michael Richardson, M.D.
• Makalyn Jenai Richardson
• Malachi Richardson
• Mathew Thomas Richardson, M.P.T.

• Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.