Provider Demographics
NPI:1609671361
Name:RICHARDSON, LEXI M
Entity type:Individual
Prefix:
First Name:LEXI
Middle Name:M
Last Name:RICHARDSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8646 GUION RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3011
Mailing Address - Country:US
Mailing Address - Phone:317-334-7331
Mailing Address - Fax:317-334-7336
Practice Address - Street 1:3106 N CANTERBURY CT
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-1500
Practice Address - Country:US
Practice Address - Phone:317-334-7331
Practice Address - Fax:317-334-7336
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician