Provider Demographics
NPI:1285321489
Name:RICHARDSON, SHARONDA (LSW)
Entity type:Individual
Prefix:
First Name:SHARONDA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PATRICK WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-1627
Mailing Address - Country:US
Mailing Address - Phone:609-937-2333
Mailing Address - Fax:
Practice Address - Street 1:5 PATRICK WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08620-1627
Practice Address - Country:US
Practice Address - Phone:609-937-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06578000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker