Pamela Marie Randolph in Leavenworth - Clinical
Pamela Marie Randolph - NPI 1740238658
Pamela Marie Randolph is a Clinical in Leavenworth, Kansas. Pamela Marie Randolph practices all healthcare services and medical treatments related to Clinical. The NPI Number for Pamela Marie Randolph is 1740238658. The last update date is 2007-07-08.
Pamela Marie Randolph's current location address is 4101 S 4th St, Leavenworth, Kansas. You can contact this provider via phone number 9136822000 and fax number 9137584149. The mailing address for Pamela Marie Randolph is 4101 S 4th St, Leavenworth, Kansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Pamela Marie Randolph |
|---|---|
| Address | 4101 S 4th St, Leavenworth, Kansas |
| Phone Number | 9136822000 |
| Fax Number | 9137584149 |
| Sole Proprietor | X |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1740238658 |
|---|---|
| Provider Enumeration Date | 2006-05-04 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4101 S 4th St |
|---|---|
| City | Leavenworth |
| State | Kansas (KS) |
| Post Code | 660485014 |
| Phone Number | 9136822000 |
| Fax Number | 9137584149 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCSW 227 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique provider identifier assigned to Pamela Marie Randolph?
The Pamela Marie Randolph has been issued the NPI (National Provider Identifier) 1740238658 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Pamela Marie Randolph?
The Pamela Marie Randolph is physically situated at 4101 S 4Th St, in the city of Leavenworth, state of KS, with the postal code 660485014.
What is the Pamela Marie Randolph's specialty and taxonomy code?
The Pamela Marie Randolph's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Pamela Marie Randolph receive its 1740238658 assignment from the Centers for Medicare & Medicaid Services?
The Pamela Marie Randolph was assigned its 1740238658 by the Centers for Medicare & Medicaid Services on 2006-05-04.
As of what date was the information regarding Pamela Marie Randolph, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Pamela Marie Randolph, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
NPI Number: 1720072812
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