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Individual

RANDY A DEEKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDCIII

Contact information

Practice address
446 MORGAN ST, CINCINNATI, OH 45206
(513) 834-7063
(513) 873-1567
Mailing address
446 MORGAN ST, CINCINNATI, OH 45206-2348
(513) 834-7063
(513) 873-1567

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161585
OH
106H00000X
Marriage & Family Therapist
Primary
F.1700005
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0214214
OH
Enumeration date
01/15/2013
Last updated
06/08/2018
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