Provider Demographics
NPI:1124576913
Name:FRITCHEN, RANNDI MARIE (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:RANNDI
Middle Name:MARIE
Last Name:FRITCHEN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:RANNDI
Other - Middle Name:MARIE
Other - Last Name:TUTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12311 BLUESTEM LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1700
Mailing Address - Country:US
Mailing Address - Phone:715-292-1988
Mailing Address - Fax:
Practice Address - Street 1:708 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4548
Practice Address - Country:US
Practice Address - Phone:704-865-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0109341041C0700X
NCC0118721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical