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NPI Code Detail

MEDICARE: RANDY KHONG LCSW

MEDICARE:   RANDY  KHONG  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker8023-CNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275086761
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY KHONG LCSW
Provider Business Mailing Address
First Line : 330 CRAMPTON ST
Second Line :
City : RENO
State : NV
Zip : 89502-2480
Country : US
Telephone Number : 775-336-3700
Fax Number : 775-336-3701
Provider Business Practice Location Address
First Line : 330 CRAMPTON ST
Second Line :
City : RENO
State : NV
Zip : 89502-2480
Country : US
Telephone Number : 775-336-3741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2016
Last Update Date : 07/21/2022

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Directions to “ RANDY KHONG LCSW” Practice Location

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