Randleman, Mary Carmen
Randleman, Mary Carmen is an sole proprietor health care provider with primary practice located at 207 N Oak St Ste 5 , Sallisaw OK 74955-4602. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Randleman, Mary Carmen can be contacted via phone (918) 724-6449.Contact Information
Primary practice address
207 N Oak St Ste 5
Sallisaw OK 74955-4602
Phone: (918) 724-6449
Fax: (918) 208-0687
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 101YS0200X | ||
| Behavioral Health & Social Service Providers / School | 103TS0200X | 229640 | Oklahoma |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | ||
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 4855 | Oklahoma |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1083875769 |
|---|---|
| LBN Legal business name | Randleman, Mary Carmen |
| Credentials | M.ED., LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 24th, 2008 |
| Last updated | Sep 29th, 2023 - about last year |
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 | 1083875769 | NPPES |
| Oklahoma | MEDICAID | 200456660 A | |
| Oklahoma | MEDICAID | 200378480 |
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