Provider Demographics
NPI:1336487271
Name:CAMIRAND, RANDI (MA, LPC)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:CAMIRAND
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 DEW RD
Mailing Address - Street 2:
Mailing Address - City:BARKHAMSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06063-3333
Mailing Address - Country:US
Mailing Address - Phone:860-995-0358
Mailing Address - Fax:
Practice Address - Street 1:95 RIVER RD
Practice Address - Street 2:SUITE C
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3201
Practice Address - Country:US
Practice Address - Phone:860-995-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2219101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional