Hart, Randolph Lee

Hart, Randolph Lee is an individual health care provider with primary practice located at 66 Club Rd Ste 120 , Eugene OR 97401-2439. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Hart, Randolph Lee can be contacted via phone (541) 393-5983.

Contact Information

Primary practice address
66 Club Rd Ste 120 Eugene OR 97401-2439
Phone: (541) 393-5983
Fax: (541) 393-5984
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6277 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 02R07 Oregon

Profile Details

NPI number 1497803027
LBN Legal business name Hart, Randolph Lee
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Mar 13th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497803027 NPPES
Oregon MEDICAID 210831
Oregon MEDICAID 500663524

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