Provider Demographics
NPI:1770936932
Name:KIRCHNER, RANDA (LCSW)
Entity type:Individual
Prefix:
First Name:RANDA
Middle Name:
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 CHERRY MOUNTAIN LOOP
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-7791
Mailing Address - Country:US
Mailing Address - Phone:210-488-3971
Mailing Address - Fax:
Practice Address - Street 1:2835 CHERRY MOUNTAIN LOOP
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-7791
Practice Address - Country:US
Practice Address - Phone:210-488-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX362041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical