Shontay Lashay Richardson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18061 Issued in CA

Practice address

2729 4TH Ave Ste 3
San Diego, CA 92103-6223

Phone

(508) 921-0428

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tay Lashay Richardson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1245959865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10623 CAMINITO CHUECO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262801",
            "telephone_number": "914-364-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 4TH AVE STE 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036223",
            "telephone_number": "508-921-0428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10623 Caminito Chueco",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921262801",
            "country_code": "US",
            "telephone_number": "508-921-0428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "SHONTAY",
        "middle_name": "LASHAY",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "18061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAY",
            "last_name": "RICHARDSON",
            "middle_name": "LASHAY",
            "credential": "LPCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Richardson
• Rodney B Richardson, PT
• Sabrina Richardson
• Saudia Richardson, PSYD
• Shannon Richardson
• Sunceree S Richardson
• Thomas James Richardson
• Victoria Alexandria Richardson
• Violet Richardson
• Frederick Allen Richburg II, MD

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.