Provider Demographics
NPI:1154787406
Name:CRIPE, RANDALL (LPC)
Entity type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:
Last Name:CRIPE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33634 W 8 MILE RD
Mailing Address - Street 2:STE. #26
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5202
Mailing Address - Country:US
Mailing Address - Phone:248-763-6490
Mailing Address - Fax:
Practice Address - Street 1:33634 W 8 MILE RD
Practice Address - Street 2:STE. #26
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5202
Practice Address - Country:US
Practice Address - Phone:248-763-6490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-01
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional