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Individual

COURTNEY BLISS RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC, LPC, LADC

Contact information

Practice address
690 ELIZABETH WAY APT 221, HUDSON, WI 54016-7400
(612) 443-6166
Mailing address
690 ELIZABETH WAY APT 221, HUDSON, WI 54016-7400
(612) 443-6166

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305869
MN
101YM0800X
Mental Health Counselor
11669-125
WI
101YM0800X
Mental Health Counselor
Primary
4209
MN

Other

Enumeration date
11/05/2025
Last updated
11/05/2025
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