Provider Demographics
NPI:1972644011
Name:RICHARDS, PAUL M (PHD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 CENTURY CIR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1696
Mailing Address - Country:US
Mailing Address - Phone:303-499-3836
Mailing Address - Fax:
Practice Address - Street 1:245 CENTURY CIR
Practice Address - Street 2:SUITE 205
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1696
Practice Address - Country:US
Practice Address - Phone:303-499-3836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1760103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical