Local City Search for Psychiatrists, Psychologists, Therapists, Counselors and Mental Health Treatment CentersDR. JOHN JAMES RANDOLPH PH.D.
Clinical Neuropsychologist
Lebanon, New Hampshire
Provider NPI: 1700881463
Provider Information:DR. JOHN JAMES RANDOLPH PH.D.
Gender: M
Sole Proprietor
Practice Location:
20 W PARK ST STE 215 LEBANON, NH 03766 US
Tel: 603-448-6779 Fax: 603-653-0246
Business Mailing Address:
20 W PARK ST SUITE 215 LEBANON, NH 03766 US
Tel: 603-653-0330 Fax: 603-653-0330
Entity Type: Individual
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | NH | 1027 |
| N | 103T00000X | Behavioral Health & Social Service Providers Psychologist | NH | 1027 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SH | 06Y007347NH01 | NH | 01 |
| BLUE CROSS BLUE SHIELD | 00068596 | VT | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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