Petersen, Randolph Scott
Petersen, Randolph Scott is an individual health care provider with primary practice located at 3400 Lebanon Rd Va Tvhs - Psychology Services (116B), Murfreesboro TN 37129-1392. He recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Petersen, Randolph Scott can be contacted via phone (615) 225-3933.Contact Information
Primary practice address
3400 Lebanon Rd Va Tvhs - Psychology Services (116B)
Murfreesboro TN 37129-1392
Phone: (615) 225-3933
Fax: (615) 225-6361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 880 | South Carolina |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 880 | South Carolina |
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | 880 | South Carolina |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 880 | South Carolina |
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | 880 | South Carolina |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 880 | South Carolina |
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | 880 | South Carolina |
Profile Details
| NPI number | 1548312549 |
|---|---|
| LBN Legal business name | Petersen, Randolph Scott |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Apr 29th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548312549 | NPPES |
| South Carolina | MEDICAID | PS0384 |
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