Reginald Charles Richardson Sr., PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

618 Library PL
Evanston, IL 60201-2908

Phone

(847) 733-4300

Fax

(847) 733-0390

NPI assigned

Feb 1, 2007

Sex

Male

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 IL

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tides Mental Health of Il, PLLCGroup PAC ID 4789044884, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Tides Mental Health of Il, PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1154014116
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508904962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 LIBRARY PL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012908",
            "telephone_number": "847-733-4300",
            "fax_number": "847-733-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 LIBRARY PL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012908",
            "telephone_number": "847-733-4300",
            "fax_number": "847-733-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "REGINALD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larkin Richards, NP
• Sarah Richards
• Amelia K Richardson, MS, CGC
• Barbara Richardson
• Porsha Richardson
• Thomas Richey
• John Wesley Richier, PA-C
• Ridge Anesthesia SC
• Jennifer Riedel
• Ellen E Rieger, LCPC

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.