Healthcare Provider Details

I. General information

NPI: 1407256662
Provider Name (Legal Business Name): RANDY ELVIN STRUNK LPCC-S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2347 VINE ST
CINCINNATI OH
45219-1745
US

IV. Provider business mailing address

5841 HAMILTON MASON RD
LIBERTY TWP OH
45011-9723
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-1117
  • Fax:
Mailing address:
  • Phone: 513-503-1859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberE2608
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE2608
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE2608
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: