Doctor Name: | MR. RANDY LEROY COUSINEAU |
NPI Number: | 1104177047 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CAADC, LPC, MLSW |
License Number: | 6401001535 |
Business Practice Address: | 1823 Commerce St. Muskegon, MI - 49411 |
Business Phone Number: | 2317282138 |
Business Fax Number: | 2317224771 |
Mailing Address: | 1823 Commerce St., West Michigan Therapy MUSKEGON |
State: | MI |
Postal Code: | 49441 |
Phone Number: | 2317282138 |
Fax Number: | 2317224771 |
NPI Enumeration Date: | 10/01/2012 |
NPI Last Update Date: | 10/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401001535 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |