Doctor Name: | MR. RANDY ERWIN MASTERSON |
NPI Number: | 1891086336 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, LPC |
License Number: | L1347692 |
Business Practice Address: | 910 E Lincoln Ave Ionia, MI - 488461393 |
Business Phone Number: | 6165506498 |
Business Fax Number: | |
Mailing Address: | 95 Summit St, SARANAC |
State: | MI |
Postal Code: | 488819533 |
Phone Number: | 6165506498 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2011 |
NPI Last Update Date: | 05/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | L1347692 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |