Chanel Lanete Richardson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 0000004526 Issued in TN

Practice address

1986 Northport Rd Apt 2
Cordova, TN 38016-3880

Phone

(317) 937-6874

NPI assigned

Feb 18, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Benevolent Care LLC.

  • In Home Supportive Care Agency
  • Indianapolis, IN
  • NPI 1174167720
  NPD Authorized official

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1669712360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1389 TURKINGTON CT",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461435518",
            "telephone_number": "317-937-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1986 NORTHPORT RD APT 2",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380163880",
            "telephone_number": "317-937-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CHANEL",
        "middle_name": "LANETE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26029048A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP 0000004526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE STATE LICENSE FOR SPEECH LANGUAGE PATHOLOGY",
            "identifier": "SP 0000004526",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "26029048A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Resurge LLC
• Reyle Counseling, LLC
• Rheumatology & Dermatology Associates, P.C.
• Rheumatology & Osteoporosis Center of Memphis, P.C
• Marlyna E Rice, LCSW LICENSED CLINIC
• Porshure Green Richardson, LCSW
• Rochelle Renee Richardson, LMT
• Samantha I Richardson, LPC-MHSP
• Willie D Richardson Sr.
• Sarah D. Richie, PHD

• Speech-Language Pathologist in Cordova, TN
• Providers in Cordova, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.