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General NPI Number Information
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NPI Number | 1154591709
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Entity Type | Individual
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Provider Name | JON RANDE HOWELL LPC
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Gender | Male
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 4525 HEDGEMORE DR SUITE M
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City | CHARLOTTE
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State | NC
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Zip | 28209-3235
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Country | US
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Telephone | 704-921-9550
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Fax |
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Provider Business Mailing Address
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Address Line | 4525 EDMONTON DRIVE SUITE M
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City | CHARLOTTE
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State | NC
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Zip | 28209-0000
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Country | US
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Telephone | 704-921-9550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3197
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License Number State | NC
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