Provider Demographics
NPI:1013593243
Name:RANDALL, ABIGAIL JOY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:JOY
Last Name:RANDALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:ABBY
Other - Middle Name:JOY
Other - Last Name:RANDALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:7159 E 123RD PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8043
Mailing Address - Country:US
Mailing Address - Phone:630-740-9702
Mailing Address - Fax:
Practice Address - Street 1:8120 SHERIDAN BLVD STE 100C
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80003-6148
Practice Address - Country:US
Practice Address - Phone:630-740-9702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016959101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty