Kimberly Elizabeth Richards, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1504 Issued in NH

Practice address

112 N Broad St
RM 821
Philadelphia, PA 19102-1512

Phone

(215) 568-0860

Fax

(215) 568-0769

NPI assigned

Dec 1, 2008

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 29, 2021 through Dec 29, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1316192560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 CORLISS LN",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "035763206",
            "telephone_number": "603-237-8336",
            "fax_number": "603-237-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N BROAD ST",
            "address_2": "RM 821",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021512",
            "telephone_number": "215-568-0860",
            "fax_number": "215-568-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KIMBERLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collin Richards, MD
• David Lawrence Richards, MD
• Deanna Marie Richards
• Denay Jada Kassandra Richards, MD PHD
• Erin Frances Richards
• Laverda Monique Richards, O.D.
• Riley Mercer Richards, PA-C
• Soledad Richards
• Angelle Elaine Richardson
• Destinee Richardson

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.