Provider Demographics
NPI:1316022163
Name:FUHRMANN, RANDALL ROY (LCPC)
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:ROY
Last Name:FUHRMANN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 HELENA AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3654
Mailing Address - Country:US
Mailing Address - Phone:406-431-0964
Mailing Address - Fax:406-442-7271
Practice Address - Street 1:616 HELENA AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3654
Practice Address - Country:US
Practice Address - Phone:406-431-0964
Practice Address - Fax:406-442-7271
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT620-LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT744833OtherMENTAL HEALTH COUNSELING
MT0000253470Medicaid