Provider Demographics
NPI:1750479523
Name:WEEKS, RANDALL S (LPC, BC-TMH)
Entity type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:S
Last Name:WEEKS
Suffix:
Gender:M
Credentials:LPC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PRIVATE ROAD 3151
Mailing Address - Street 2:APARTMENT 6
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655
Mailing Address - Country:US
Mailing Address - Phone:662-458-9740
Mailing Address - Fax:
Practice Address - Street 1:2690 WEST OXFORD LOOP, SUITE 146
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-458-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional