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Individual
RANDALL CARMACK
Active
Individual
RANDALL CARMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCDCIII.162264
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
162422
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
162458
OH
1041C0700X
Clinical Social Worker
Primary
I.2507266
OH
175T00000X
Peer Specialist
APS.000660
OH
Other
Enumeration date
01/18/2018
Last updated
12/10/2025
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