Provider Demographics
NPI:1205086873
Name:CALE, RANDY L (PHD)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:L
Last Name:CALE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 PLANK RD
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2042
Mailing Address - Country:US
Mailing Address - Phone:518-383-0600
Mailing Address - Fax:
Practice Address - Street 1:636 PLANK RD
Practice Address - Street 2:SUITE # 200
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-2042
Practice Address - Country:US
Practice Address - Phone:518-383-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010329-1103T00000X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily