Michael Keith Richardson, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW-41596 Issued in ID

Practice address

12271 Hartford Ave
Orofino, ID 83544-9348

Phone

(208) 471-8079

Fax

(877) 775-0174

NPI assigned

Jun 23, 2015

Sex

Male

Sole proprietor

Yes

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.

• Michael K. Richardson

  • Clinical Social Worker
  • Orofino, ID
  • NPI 1366171753
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 6, 2022.

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1780066050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835440381",
            "telephone_number": "208-471-8079",
            "fax_number": "877-775-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12271 HARTFORD AVE",
            "city": "OROFINO",
            "state": "ID",
            "postal_code": "835449348",
            "telephone_number": "208-471-8079",
            "fax_number": "877-775-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MICHAEL",
        "middle_name": "KEITH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-41596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damon Josef Popovics, DC
• Bridgette Presnell
• Suzi M Quintal, LMSW
• David Michael Rees, C.R.N.A.
• Richardson Enterprises, Inc.
• Glenn Urban Richey, D.D.S.
• John Edward Riley, M.D.
• Riverside Recovery
• Charity D Robinson
• James Z Said, DC, ND

• All providers in Orofino, ID
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.