Richards, Kevin J

Richards, Kevin J is an sole proprietor health care provider with primary practice located at 199 Frasier St Se , Marietta GA 30060-2201. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Forensic is his primary health care specialty. Richards, Kevin J can be contacted via phone (678) 310-3442.

Contact Information

Primary practice address
199 Frasier St Se Marietta GA 30060-2201
Phone: (678) 310-3442
Fax: (678) 564-4401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X PSY002508 Georgia
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY002508 Georgia

Profile Details

NPI number 1396838983
LBN Legal business name Richards, Kevin J
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Jun 29th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396838983 NPPES
Georgia MEDICAID 000950441A

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