Individual
VENITA CATRICE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LPCS, LAC
Contact information
Practice address
657 TWINFLOWER ST, LITTLE RIVER, SC 29566-7444
(704) 561-1913
Mailing address
PO BOX 924, NORTH MYRTLE BEACH, SC 29597-0924
(843) 945-0658
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/19/2007
Last updated
10/28/2024
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