Provider Demographics
NPI:1730965625
Name:RICHARDS, WILLIAM IV (MSED)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:RICHARDS
Suffix:IV
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 153RD ST APT 446
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11367-4001
Mailing Address - Country:US
Mailing Address - Phone:718-510-5989
Mailing Address - Fax:
Practice Address - Street 1:7525 153RD ST APT 446
Practice Address - Street 2:
Practice Address - City:KEW GARDENS HILLS
Practice Address - State:NY
Practice Address - Zip Code:11367-4001
Practice Address - Country:US
Practice Address - Phone:718-510-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty