Provider Demographics
NPI:1902587611
Name:SALMONS, RANDY (LMHC)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:SALMONS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 940412
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-0412
Mailing Address - Country:US
Mailing Address - Phone:407-628-7088
Mailing Address - Fax:
Practice Address - Street 1:209 QUAYSIDE CIR
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5782
Practice Address - Country:US
Practice Address - Phone:407-628-7088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health