Active NPI
Rory Fleming Richardson, PH.D., FICPPM
- Psychologist
- Lincoln City, OR
National Provider Identifier
1629051776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1249
- Practice address
- 4466 NE Devils Lake Blvd
Suite a
Lincoln City, OR 97367-5197 - Phone
- (541) 994-4462
- Fax
- (541) 994-6329
- NPI assigned
- Nov 22, 2005
- Last updated
- Oct 18, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C0068 | OR | |
| Clinical Neuropsychologist | 103G00000X | 1249 | OR | |
| Psychologist | 103T00000X | 1249 | OR | Primary |
Addresses
Primary practice location
4466 NE Devils Lake Blvd
Suite a
Lincoln City, OR 97367-5197
Mailing address
P.O. Box 109
Lincoln City, OR 97367-0109
Phone (541) 994-4462
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092951 | Medicaid | OR | |
| 150576 | Medicaid | OR | |
| 171641 | Other | OR | MENTAL HEALTH NETWORK |
| 069078000 | Other | OR | REGENCE BLUE CROSS BLUE S |
| R 7WBQ0 | Other | OR | PACC HMO |
| OR00543 | Other | MEDICARE NORIDIAN EDI | |
| 090021822 | Other | OR | STATE OF OREGON DDS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0068 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1792281600000",
"number": "1629051776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 109",
"city": "LINCOLN CITY",
"state": "OR",
"postal_code": "973670109",
"telephone_number": "541-994-4462",
"fax_number": "541-994-6329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4466 NE DEVILS LAKE BLVD",
"address_2": "SUITE A",
"city": "LINCOLN CITY",
"state": "OR",
"postal_code": "973675197",
"telephone_number": "541-994-4462",
"fax_number": "541-994-6329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "RORY",
"middle_name": "FLEMING",
"name_prefix": "Dr.",
"credential": "PH.D., FICPPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2026-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C0068",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "OR",
"license": "1249",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "1249",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092951",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150576",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH NETWORK",
"identifier": "171641",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE CROSS BLUE S",
"identifier": "069078000",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACC HMO",
"identifier": "R 7WBQ0",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NORIDIAN EDI",
"identifier": "OR00543",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OREGON DDS",
"identifier": "090021822",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.