Provider Demographics
NPI:1073967139
Name:RICHMOND, KACY (MD)
Entity type:Individual
Prefix:DR
First Name:KACY
Middle Name:
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5941
Mailing Address - Country:US
Mailing Address - Phone:973-925-6200
Mailing Address - Fax:973-925-6201
Practice Address - Street 1:13 JAMES ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5941
Practice Address - Country:US
Practice Address - Phone:973-925-6200
Practice Address - Fax:973-925-6201
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4725582084P0800X
NM390200000X
NJ25MA110211002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program