Keryn Richards, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-35908 Issued in ID

Practice address

1055 E Timber LN
Coeur D Alene, ID 83815-6508

Phone

(208) 818-0303

NPI assigned

Aug 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Crescent Moon Counseling, LLC

  • Adult Mental Health Clinic/Center
  • Coeur D Alene, ID
  • NPI 1518592344
  NPD Authorized official

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1780130666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E TIMBER LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838156508",
            "telephone_number": "208-818-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E TIMBER LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838156508",
            "telephone_number": "208-818-0303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 E Polston Ave",
            "address_2": "ste A",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838546045",
            "country_code": "US",
            "telephone_number": "208-457-1540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KERYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-35908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Rezzonico, PMHNP
• Kelly Rhoads, LCSW
• Jennifer Rhodes, MD
• Alissa M Rice, LMSW
• Andrea Kaye Rice, LPC
• Cory Glen Richardson, MD
• Hayden Richardson
• Clark Edward Richman, LCPC
• Rick Westby Therapy PLLC
• Jada Rickheim, ARNP

• Social Worker in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.