Provider Demographics
NPI:1982404224
Name:LAMONS, RANDALL ALEX (M ED)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:ALEX
Last Name:LAMONS
Suffix:
Gender:
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 WAYBILL CIR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30461-0026
Mailing Address - Country:US
Mailing Address - Phone:706-830-4777
Mailing Address - Fax:
Practice Address - Street 1:214 WAYBILL CIR
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30461-0026
Practice Address - Country:US
Practice Address - Phone:706-830-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health