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MR. RANDALL ANCIL CAMPBELL LICSW, CADC, CRSS

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1366030124

Individual Registrant:
MR. RANDALL ANCIL CAMPBELL LICSW, CADC, CRSS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
216 2ND ST SW  GORDO, AL 35466-2221 US
Tel: 205-331-3836  Fax: --

Contact information for business:
1761 COMMONS NORTH LOOP UNIT 4103  TUSCALOOSA, AL 35406-3591 US
Tel: 205-394-3765  Fax: --

Registration Information:
NPI: 1366030124
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
ALADC-907
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
AL4477C
N175T00000X
ALCRSS-0348

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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