Provider Demographics
NPI:1871710301
Name:RICHMAN, ELIZABETH R (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:R
Last Name:RICHMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PENNSYLVANIA AVE
Mailing Address - Street 2:#21 C 45
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130
Mailing Address - Country:US
Mailing Address - Phone:267-319-1139
Mailing Address - Fax:215-247-0905
Practice Address - Street 1:133 COULTER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003
Practice Address - Country:US
Practice Address - Phone:610-896-8666
Practice Address - Fax:610-896-8665
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003186-L103TC2200X
PS003186-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent