Active NPI
Carolyn Richardson, LSW
- Professional Counselor
- Youngstown, OH
National Provider Identifier
1831257302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- S0023404
- Practice address
- 535 Marmion Ave
Youngstown, OH 44502-2323 - Phone
- (330) 782-5664
- Fax
- (330) 782-1614
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | S0023404 | OH | Primary |
Addresses
Primary practice location
535 Marmion Ave
Youngstown, OH 44502-2323
Mailing address
535 Marmion Ave
Youngstown, OH 44502-2323
Phone (330) 782-5664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0803312 | Medicaid | OH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S0023404 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328486400000",
"number": "1831257302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 MARMION AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445022323",
"telephone_number": "330-782-5664",
"fax_number": "330-782-1614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 MARMION AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445022323",
"telephone_number": "330-782-5664",
"fax_number": "330-782-1614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "CAROLYN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2012-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "S0023404",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0803312",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.