DR. CAROL LACEY RICHARDSON (PHD) – Psychologist, NPI 1780950436

DR. CAROL LACEY RICHARDSON (PHD) is a healthcare provider. based in Fort worth, Texas. specializing in Psychologist. They hold the professional credentials PHD. They hold a License No. 35034 (TX). The NPI Number for DR. CAROL LACEY RICHARDSON (PHD) is 1780950436

Main info

Female
Sole Proprietor
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. CAROL LACEY RICHARDSON (PHD)
NPI
1780950436
Phone
(817) 542-2595
Address
4316 LAKE STONE TRL
Enumeration Date
27 March 2012
Last Update Date
27 March 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8175330825
Graduation Year
2005 (21 years ago)
PAC ID
8628232030
Group Practice PAC ID
1951551076
Professional Enrollment ID
I20120615000251
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for DR. CAROL LACEY RICHARDSON (PHD)

  • 4316 LAKE STONE TRL

    FORT WORTH, TX 761238009

    Phone: (817) 542-2595

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-06-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120615000251IClinical PsychologistTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76123)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951551076View full group profile
NameSpecialtyState
Clinical PsychologistTX
Clinical PsychologistTX
-TX
-TX

Reviews

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Frequently asked questions

What NPI should I save for DR. CAROL LACEY RICHARDSON (PHD)?
Save NPI 1780950436 if you need a stable reference for DR. CAROL LACEY RICHARDSON (PHD).
Is DR. CAROL LACEY RICHARDSON (PHD) active in the national directory?
DR. CAROL LACEY RICHARDSON (PHD)'s public NPI profile is in an active state.
Can you summarize DR. CAROL LACEY RICHARDSON (PHD)'s specialty in plain language?
Clinically, the directory lists DR. CAROL LACEY RICHARDSON (PHD) with Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place DR. CAROL LACEY RICHARDSON (PHD)?
The snapshot lists Fort Worth, Texas for DR. CAROL LACEY RICHARDSON (PHD); download NPPES for the complete set.
How can I contact DR. CAROL LACEY RICHARDSON (PHD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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