| Jennifer Richardson Psyd, Pa | |
|
20747 Sterlington Dr Land O Lakes FL 34638-4317 | |
| (813) 907-9191 | |
| (813) 948-0094 |
| Full Name | Jennifer Richardson Psyd, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 20747 Sterlington Dr, Land O Lakes, Florida |
| Authorized Official Name and Position | Jennifer Anne Richardson (PRESIDENT) |
| Authorized Official Contact | 7276885756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Richardson Psyd, Pa 20747 Sterlington Dr Land O Lakes FL 34638-4317 Ph: (727) 688-5756 | Jennifer Richardson Psyd, Pa 20747 Sterlington Dr Land O Lakes FL 34638-4317 Ph: (813) 907-9191 |
| NPI Number | 1992285936 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 06/06/2019 |
| Medicare PECOS PAC ID | 6204250129 |
|---|---|
| Medicare Enrollment ID | O20200723002801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992285936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY10020 (Florida) | Primary |
| Provider Name | Jennifer Anne Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164638896 PECOS PAC ID: 4688913056 Enrollment ID: I20200723003429 |
| Provider Name | Sharon M Maisonet |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609637693 PECOS PAC ID: 3274973300 Enrollment ID: I20240506003701 |
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