Provider Demographics
NPI:1548656622
Name:WITHERS, RANDAL WAYNE (NCC LCMHC LCAS)
Entity type:Individual
Prefix:MR
First Name:RANDAL
Middle Name:WAYNE
Last Name:WITHERS
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Gender:M
Credentials:NCC LCMHC LCAS
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Mailing Address - Street 1:104 N GREEN ST UNIT 148
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3422
Mailing Address - Country:US
Mailing Address - Phone:282-012-7788
Mailing Address - Fax:828-282-0899
Practice Address - Street 1:715 FAIRGROVE CHURCH RD SE STE 202
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9289
Practice Address - Country:US
Practice Address - Phone:828-201-2778
Practice Address - Fax:828-282-0899
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2025-05-19
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Provider Licenses
StateLicense IDTaxonomies
NC11110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health