Individual
RANDALL EUGENE CLECKLER
Active
Individual
RANDALL EUGENE CLECKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1167C
AL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
1167C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51550439
—
AL
01
—
51550439CLE
BCBS OF AL PROVIDER
AL
Enumeration date
01/22/2007
Last updated
07/10/2008
Update your record
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