Provider Demographics
NPI:1013120088
Name:LEVIN, RANDI B (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:RANDI
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 N LAST CHANCE GULCH ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4109
Mailing Address - Country:US
Mailing Address - Phone:406-443-8780
Mailing Address - Fax:406-443-4550
Practice Address - Street 1:21 N LAST CHANCE GULCH ST
Practice Address - Street 2:SUITE 209
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4109
Practice Address - Country:US
Practice Address - Phone:406-443-8780
Practice Address - Fax:406-443-4550
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLCSW 4781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT502860Medicaid