Individual
MR. RANDOLPH LEE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
66 CLUB RD STE 120, EUGENE, OR 97401-2439
(541) 393-5983
(541) 393-5984
Mailing address
66 CLUB RD STE 120, EUGENE, OR 97401-2439
(541) 393-5983
(541) 393-5984
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
02R07
OR
1041C0700X
Clinical Social Worker
Primary
6277
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210831
—
OR
05
—
500663524
—
OR
Enumeration date
01/08/2007
Last updated
03/13/2023
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