Shaconya L Richardson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3010019 Issued in KY

Practice address

714 Lyndon LN Ste 6
Louisville, KY 40222-4643

Phone

(502) 243-5565

NPI assigned

Feb 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Elizabethtown Partners in Counseling Inc

  • Psychologist
  • Elizabethtown, KY
  • NPI 1841399789
  Medicare reassignment NPD
• Havehope Counseling & Consulting, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
  • NPI 1568023661

  Family

  Medicare reassignment NPD
• Medoptions of Kentucky LLC

  • Psychiatry Physician
  • Frankfort, KY
  • NPI 1518412121
  Medicare reassignment NPD
• Shaconya L Richardson

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
  • NPI 1548916810
  NPD

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1427417153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 COUNT TURF DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402723549",
            "telephone_number": "502-243-5565",
            "fax_number": "502-772-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 LYNDON LN STE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224643",
            "telephone_number": "502-243-5565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 S Roy Wilkins Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402032072",
            "country_code": "US",
            "telephone_number": "502-583-6990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "SHACONYA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010019",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28196212A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3010019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100443600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Richardson
• Lisa Jo Richardson
• Mark E Richardson, MD
• Oliver Buren Richardson, LCADC, CSW
• Ronald L Richardson, MD
• Stacy D Richardson, PHARM D
• Tori Richardson
• Tricia Richardson, APRN
• Ty E Richardson, MD
• Whitney Richardson

• Psychiatric/Mental Health Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.