NPIMap

Organization Active NPI

Deryck D. Richardson, PH.D. LLC

  • Adult Mental Health Clinic/Center
  • Columbus, OH
National Provider Identifier
1629340914
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
2950 Issued in OH
Legal business name
DERYCK D. RICHARDSON, PH.D. LLC
Practice address
1425 E Dublin Granville Rd
Suite 204
Columbus, OH 43229-3325
Phone
(614) 888-5255
Fax
(614) 888-2306
NPI assigned
Feb 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Dr. Deryck D'Arcy Richardson, PH.D.NPI 1194887224
Title
President
Phone
(614) 888-5255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 2950 OH Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 2950 OH

Addresses

Primary practice location

1425 E Dublin Granville Rd
Suite 204
Columbus, OH 43229-3325

Mailing address

1425 E Dublin Granville Rd
Suite 204
Columbus, OH 43229-3325
Phone (614) 888-5255

Other identifiers 1

IdentifierTypeStateIssuer
0453389MedicaidOH

National Provider Directory

National Provider Directory

Locations

1425 E Dublin Granville Rd
Ste 204
Columbus, OH 43229
Phone (614) 888-5255

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1629340914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 E DUBLIN GRANVILLE RD",
            "address_2": "SUITE 204",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293325",
            "telephone_number": "614-888-5255",
            "fax_number": "614-888-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 E DUBLIN GRANVILLE RD",
            "address_2": "SUITE 204",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293325",
            "telephone_number": "614-888-5255",
            "fax_number": "614-888-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERYCK D. RICHARDSON, PH.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "DERYCK",
        "authorized_official_middle_name": "D'ARCY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-888-5255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OH",
            "license": "2950",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OH",
            "license": "2950",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0453389",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.