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Individual

MR. BILLY DEAN RANDOLPH II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13873545-3501
UT
1041C0700X
Clinical Social Worker
Primary
9730
TN

Other

Enumeration date
06/11/2018
Last updated
04/20/2026
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