Provider Demographics
NPI:1619638517
Name:STINSON-RICHARDSON, AYANA
Entity type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:STINSON-RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18134 SW 98TH AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5585
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16688 HIGHLANDS PKWY
Practice Address - Street 2:
Practice Address - City:WHITETOP
Practice Address - State:VA
Practice Address - Zip Code:24292-2652
Practice Address - Country:US
Practice Address - Phone:540-293-1244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health