Provider Demographics
NPI:1114201407
Name:EHRHARDT, RICHARD JAMES (LMHC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:EHRHARDT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 HEALTH CARE DR STE B
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5377
Mailing Address - Country:US
Mailing Address - Phone:727-358-9911
Mailing Address - Fax:727-499-2612
Practice Address - Street 1:1815 HEALTH CARE DR STE B
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5377
Practice Address - Country:US
Practice Address - Phone:727-358-9911
Practice Address - Fax:727-499-2612
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 8191101YM0800X
FLMH11616101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health