Slavens, Randall Lee

Slavens, Randall Lee is an individual health care provider with primary practice located at 151 S 4Th St Suite 401, Grand Forks ND 58201-4715. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Slavens, Randall Lee can be contacted via phone (701) 795-3000.

Contact Information

Primary practice address
151 S 4Th St Suite 401 Grand Forks ND 58201-4715
Phone: (701) 795-3000
Fax: (701) 795-3050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1959 North Dakota

Profile Details

NPI number 1225070865
LBN Legal business name Slavens, Randall Lee
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2006
Last updated Jul 9th, 2007 - about 17 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 1225070865 NPPES
North Dakota MEDICAID 054519
North Dakota Other 73B47SL
North Dakota Other 020530

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