Healthcare Provider Details

I. General information

NPI: 1013593243
Provider Name (Legal Business Name): ABIGAIL JOY RANDALL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ABBY JOY RANDALL LPC

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6165 LEHMAN DR STE 203
COLORADO SPRINGS CO
80918-5406
US

IV. Provider business mailing address

6165 LEHMAN DR STE 203
COLORADO SPRINGS CO
80918-5406
US

V. Phone/Fax

Practice location:
  • Phone: 630-740-9702
  • Fax:
Mailing address:
  • Phone: 630-740-9702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0016959
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: