Individual
MR. KING RICHARD RANDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, CADAC, ICADC
Contact information
Practice address
590 S OCOTILLO AVE, BENSON, AZ 85602-6405
(520) 586-7080
(520) 586-6104
Mailing address
611 W UNION ST, BENSON, AZ 85602-6718
(520) 586-0800
(520) 586-0116
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CADAC-1607
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
ICADC-122108
AZ
101YP2500X
Professional Counselor
Primary
LPC-1244
AZ
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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