Provider Demographics
NPI:1407586100
Name:SHAMITZ, RANDI (LPC-A)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:SHAMITZ
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GRAND ST APT 225
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3526
Mailing Address - Country:US
Mailing Address - Phone:203-216-7940
Mailing Address - Fax:
Practice Address - Street 1:25 GRAND ST APT 225
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-3526
Practice Address - Country:US
Practice Address - Phone:203-216-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor