Provider Demographics
NPI:1427140292
Name:RANDICH-DUMAS, PATRICIA ANN (LCSW-PIP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:RANDICH-DUMAS
Suffix:
Gender:F
Credentials:LCSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1598 GILMER AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-5620
Mailing Address - Country:US
Mailing Address - Phone:334-834-7523
Mailing Address - Fax:
Practice Address - Street 1:1598 GILMER AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-5620
Practice Address - Country:US
Practice Address - Phone:334-834-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1728C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker