Swanson, Randy Judd

Swanson, Randy Judd is an individual health care provider with primary practice located at 6040 Earle Brown Dr , Brooklyn Center MN 55430-2514. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Swanson, Randy Judd can be contacted via phone (952) 666-5896.

Contact Information

Primary practice address
6040 Earle Brown Dr Brooklyn Center MN 55430-2514
Phone: (952) 666-5896
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2758 Minnesota

Profile Details

NPI number 1528155140
LBN Legal business name Swanson, Randy Judd
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2006
Last updated Nov 16th, 2017 - about 8 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 1528155140 NPPES
Minnesota MEDICAID 950557100

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