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Individual

MR. RANDALL ANCIL CAMPBELL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW, CADC, CRSS

Contact information

Practice address
212 W TROY ST STE B, DOTHAN, AL 36303-4455
(205) 394-3765
Mailing address
212 W TROY ST STE B, DOTHAN, AL 36303-4455
(205) 394-3765

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADC-907
AL
1041C0700X
Clinical Social Worker
Primary
4477C
AL
175T00000X
Peer Specialist
CRSS-0348
AL

Other

Enumeration date
01/07/2021
Last updated
07/16/2024
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