Active NPI
Kelly Nicole Richardson, LCSW-C
- Mental Health Counselor
- Gwynn Oak, MD
National Provider Identifier
1558769661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 17243
- Practice address
- 6707 Whitestone Rd
Gwynn Oak, MD 21207-4106 - Phone
- (410) 265-8737
- Fax
- (410) 265-1258
- NPI assigned
- Dec 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 781387 | MD | |
| Mental Health Counselor | 101YM0800X | 17243 | MD | Primary |
Addresses
Primary practice location
6707 Whitestone Rd
Gwynn Oak, MD 21207-4106
Mailing address
6707 Whitestone Rd
Gwynn Oak, MD 21207-4106
Phone (410) 265-8737
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17243 | MD | MD | Mental Health Counselor |
| 781387 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Health Systems, Inc | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Baltimore, MD
- NPI 1053445171
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556582400000",
"number": "1558769661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6707 WHITESTONE RD",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212074106",
"telephone_number": "410-265-8737",
"fax_number": "410-265-1258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6707 WHITESTONE RD",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212074106",
"telephone_number": "410-265-8737",
"fax_number": "410-265-1258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KELLY",
"middle_name": "NICOLE",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2019-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "781387",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "17243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gwynn Oak, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.