Provider Demographics
NPI:1922233097
Name:RASCO, RANDI (LPC)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:RASCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-2947
Mailing Address - Country:US
Mailing Address - Phone:254-742-1524
Mailing Address - Fax:254-742-0789
Practice Address - Street 1:601 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-2947
Practice Address - Country:US
Practice Address - Phone:254-742-1524
Practice Address - Fax:254-742-0789
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional