Provider Demographics
NPI:1316351596
Name:RICHARDSON, ERIN J (LCPC - S)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:J
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LCPC - S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 LUKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5310
Mailing Address - Country:US
Mailing Address - Phone:443-415-0248
Mailing Address - Fax:
Practice Address - Street 1:4640 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-1407
Practice Address - Country:US
Practice Address - Phone:443-296-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4627101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional