Provider Demographics
NPI:1902388630
Name:MCGRATH, RANDALL THOMAS JR (MS, LMFT)
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:THOMAS
Last Name:MCGRATH
Suffix:JR
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:JR
Other - Middle Name:
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:912 SANDY COVE LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3325
Mailing Address - Country:US
Mailing Address - Phone:970-430-6397
Mailing Address - Fax:
Practice Address - Street 1:912 SANDY COVE LN
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3325
Practice Address - Country:US
Practice Address - Phone:970-430-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001510106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist