Randolph, John James

Randolph, John James is an sole proprietor health care provider with primary practice located at 20 W Park St Ste 215, Lebanon NH 03766-1378. He recently has 2 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 / Clinical Neuropsychologist is his primary health care specialty. Randolph, John James can be contacted via phone (603) 448-6779.

Contact Information

Primary practice address
20 W Park St Ste 215 Lebanon NH 03766-1378
Phone: (603) 448-6779
Fax: (603) 653-0246
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 1027 New Hampshire
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1027 New Hampshire

Profile Details

NPI number 1700881463
LBN Legal business name Randolph, John James
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2005
Last updated Mar 4th, 2014 - about 11 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 1700881463 NPPES
Vermont Other 00068596 BLUE CROSS BLUE SHIELD
Vermont Other 06Y007347NH01 BLUE CROSS BLUE SHIELD

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