Shane, Randie

Shane, Randie is an sole proprietor health care provider with primary practice located at 2460 Fairmount Blvd, #326 , Cleveland Heights OH 44106. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Shane, Randie can be contacted via phone (917) 478-1254.

Contact Information

Primary practice address
2460 Fairmount Blvd, #326 Cleveland Heights OH 44106
Phone: (917) 478-1254
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 001248 New York
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X F.1700018 Ohio
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X F1700018 Ohio

Profile Details

NPI number 1467822023
LBN Legal business name Shane, Randie
Credentials IMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2015
Last updated Dec 12th, 2018 - 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 1467822023 NPPES
Ohio MEDICAID 0239788

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