Provider Demographics
NPI:1487700027
Name:RICHARDSON, ROBIN (LCSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8841 KIND DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4419
Mailing Address - Country:US
Mailing Address - Phone:217-621-2214
Mailing Address - Fax:
Practice Address - Street 1:144 N DITHRIDGE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2659
Practice Address - Country:US
Practice Address - Phone:412-683-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410368OtherUPMC HEALTH PLAN PROVIDER