Provider Demographics
NPI:1548358849
Name:RANDALL-DODD, ELIZABETH (LPCC LICDC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RANDALL-DODD
Suffix:
Gender:F
Credentials:LPCC LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 GRAHAM RD
Mailing Address - Street 2:RESERVE PSYCHOLOGICAL CONSULTANTS INC STE A
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223
Mailing Address - Country:US
Mailing Address - Phone:330-929-1326
Mailing Address - Fax:330-929-1327
Practice Address - Street 1:96 GRAHAM RD
Practice Address - Street 2:RESERVE PSYCHOLOGICAL CONSULTANTS INC STE A
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223
Practice Address - Country:US
Practice Address - Phone:330-929-1326
Practice Address - Fax:330-929-1327
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0001767101YP2500X
OH933696101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)