Provider Demographics
NPI:1992078851
Name:RICHMOND COUNSELING INC.
Entity type:Organization
Organization Name:RICHMOND COUNSELING INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICHMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:612-229-1088
Mailing Address - Street 1:4886 HIGHWAY 61 N STE L3
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-2858
Mailing Address - Country:US
Mailing Address - Phone:612-229-1088
Mailing Address - Fax:612-444-3786
Practice Address - Street 1:4886 HIGHWAY 61 N STE L3
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-2858
Practice Address - Country:US
Practice Address - Phone:612-229-1088
Practice Address - Fax:612-444-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLMFT1397106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty