Individual
NICOLE RG RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW CADC
Contact information
Practice address
322 MAIN ST, BAR HARBOR, ME 04609-1648
(207) 288-8604
Mailing address
322 MAIN ST FL 3, BAR HARBOR, ME 04609-1648
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC6664
ME
1041C0700X
Clinical Social Worker
Primary
LC17326
ME
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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