Angela Richerson, M.S., L.A.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A0504029 Issued in AR

Practice address

2410 Pine St
Arkadelphia, AR 71923-4335

Phone

(870) 245-2210

Fax

(870) 245-2225

NPI assigned

Mar 7, 2007

Last updated

Dec 12, 2007By the provider in NPPES

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

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Experience Counseling Clinic, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hope, AR
  • NPI 1659035616
  Medicare reassignment NPD

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1982734950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 PINE ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719234335",
            "telephone_number": "870-245-2210",
            "fax_number": "870-245-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 PINE ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719234335",
            "telephone_number": "870-245-2210",
            "fax_number": "870-245-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERSON",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "M.S., L.A.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "A0504029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bret Ashton Renfro
• Stephanie Reynolds
• Caliegh Jade Rhodes
• Chasity Rhodes
• Jaclyn Richardson
• Kimberly Rickett
• Yuliya Riddle
• Carri Lynn Riley
• Rivendell - Outreach Arkadelphia (UHS of Benton)
• Johnathan Shane Roach

• Professional Counselor in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.