Dr Michael David Richardson, EDD, LCPC, CRADC | |
12496 Old 79, New London, MO 63459-2741 | |
(573) 248-2051 | |
(573) 248-2051 |
Full Name | Dr Michael David Richardson |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 12496 Old 79, New London, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154510196 | NPI | - | NPPES |
498873918 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 001395 (Missouri) | Primary |
101YP2500X | Counselor - Professional | 180.002197 (Illinois) | Secondary |
Entity Name | Walters Walk |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609442441 PECOS PAC ID: 0547619819 Enrollment ID: O20231212001689 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael David Richardson, EDD, LCPC, CRADC 12496 Old 79, New London, MO 63459-2741 Ph: (573) 248-2051 | Dr Michael David Richardson, EDD, LCPC, CRADC 12496 Old 79, New London, MO 63459-2741 Ph: (573) 248-2051 |
Kim Robinson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12662 Saverton West Dr, New London, MO 63459 Phone: 573-248-7176 | |
Angela B Warfield, PLPC, CRADC Counselor Medicare: Medicare Enrolled Practice Location: 12677 Heavenly Acres Dr, New London, MO 63459 Phone: 573-248-1372 | |
Kara Bates, LPC, CRC Counselor Medicare: Medicare Enrolled Practice Location: 12451 Stable Dr, New London, MO 63459 Phone: 573-207-9338 | |
Amber Roberts, MS PLPC/CRADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12677 Heavenly Acres Dr, New London, MO 63459 Phone: 573-248-1372 Fax: 573-248-1375 |