Individual
MR. BENJAMIN MATHIAS RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, SWLC, LAC
Contact information
Practice address
1231 N 29TH ST, BILLINGS, MT 59101-0122
(406) 248-3175
(406) 248-3821
Mailing address
1231 N 29TH ST, BILLINGS, MT 59101-0122
(406) 248-3175
(406) 248-3821
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC-LAC-LIC-4198
MT
1041C0700X
Clinical Social Worker
Primary
32769
MT
Other
Enumeration date
11/11/2014
Last updated
10/17/2018
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