Provider Demographics
NPI:1356096275
Name:STERN, RANDY LIPMAN (LCSW)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:LIPMAN
Last Name:STERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20730 NE 30TH PL
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3616
Mailing Address - Country:US
Mailing Address - Phone:786-200-5060
Mailing Address - Fax:
Practice Address - Street 1:20730 NE 30TH PL
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3616
Practice Address - Country:US
Practice Address - Phone:786-200-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW195541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical