Healthcare Provider Details

I. General information

NPI: 1013562420
Provider Name (Legal Business Name): RANDALL A HESTER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2019
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 HARRISON ST
GRAND LEDGE MI
48837-1577
US

IV. Provider business mailing address

311 HARRISON ST
GRAND LEDGE MI
48837-1577
US

V. Phone/Fax

Practice location:
  • Phone: 517-338-3090
  • Fax: 517-338-3090
Mailing address:
  • Phone: 517-338-3090
  • Fax: 517-338-3090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401223799
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: