MR. BRUCE WALTER RICHARDSON (NPI# 1467514471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467514471 |
| Entity Type | Individual |
| Full Name | MR. BRUCE WALTER RICHARDSON |
| Practice Address |
977 Taylor St Sw # A Conyers GA 30012-5357 |
| Mailing Address |
4705 Treehills Pkwy Stone Mountain GA 30088-3053 |
| Practice Telephone | 7707855910 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982031316 | Bruce Levoyle Richardson | Dentist | 3048 Sw Comus St, Portland, OR 97219-7692 | 2013-09-30 |
| 1033420732 | Bruce Coral Richardson | Occupational Therapist | 272 Glenrobin Dr, Eden, NC 27288-8094 | 2010-06-28 |
| 1427020940 | Bruce W Richardson | Family Medicine | 10505 River Rd, Havre, MT 59501-8235 | 2006-02-07 |
| 1205059680 | Bruce C Richardson | Chiropractor | 8440 W Thunderbird Rd, Peoria, AZ 85381-4803 | 2007-04-11 |
| 1477638989 | Bruce C Richardson | Internal Medicine | 1500 East Medical Center Dr, 3rd Floor Taubman Ctr Recp A, Ann Arbor, MI 48109-5370 | 2006-10-25 |
| 1306959424 | Bruce W Richardson | Dentist | 317 W Cherry Ln, Meridian, ID 83642-1608 | 2006-08-15 |
| 1295779346 | Bruce L. Richardson Jr. | Military Health Care Provider | 937 Franklin Ave, Branch Health Clinic Lemoore, Lemoore, CA 93246-0001 | 2006-06-16 |
| 1699736066 | Bruce Wiles Richardson | Family Medicine | 150 Emerson Ave E, Suite 100, Saint Paul, MN 55118-2535 | 2006-03-28 |
| Street Address |
977 TAYLOR ST SW # A |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-5357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013078062 | Latisha Jones Walker | Social Worker | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-13 |
| 1851512172 | Falesha Robinson | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2007-05-02 |
| 1720141765 | Angie Villanueva | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-19 |
| 1972665917 | Latanya Lowe | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-15 |
| 1407918212 | Tanya Parker | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-15 |
| 1376605345 | Suzan Greene Bryceland | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-15 |
| 1730241761 | Laurie Daniel | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-15 |
| 1326100173 | Talitha Mazyck | Counselor | 977 Taylor St Sw # A, Conyers, GA 30012-5357 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1093326217 | Shaunda Ayana Jones | Counselor | 2124 Blueberry Ln, Conyers, GA 30013-1476 | 2020-08-11 |
| 1508484627 | Star-jabrea Farrington | Counselor | 323 Saint Clair Dr, Conyers, GA 30094-4968 | 2020-07-07 |
| 1588138911 | Candice Waller | Counselor | 2856 Bridle Creek Dr Sw, Conyers, GA 30094-5677 | 2019-01-18 |
| 1336636133 | Friends In Transformation LLC | Counselor | 2031 Gees Mill Rd Ne Ste 102, Conyers, GA 30013-1328 | 2018-04-17 |
| 1457853160 | Charonda Gardner | Counselor | 3205 Salem Rd Se, Conyers, GA 30013-5302 | 2018-03-08 |
| 1083124762 | Graceol Counseling Center Inc | Counselor | 1035 Honey Creek Rd Se, Conyers, GA 30013-2948 | 2017-10-06 |
| 1356851547 | Melissa Morgan | Counselor | 532 Saint Clair Dr, Conyers, GA 30094-4972 | 2017-10-03 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1225570062 | Lakesha Link | Counselor | 1936 Iris Dr Sw, Conyers, GA 30094-1245 | 2016-11-10 |
| Find all providers in CONYERS | ||||
Please comment or provide details below to improve the information on MR. BRUCE WALTER RICHARDSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.