Randy A Hultberg, LCSW
Social Worker, Clinical in Greenville, KY. Individual provider (NPI-1).
NPI number1104846575
StatusActive
Last updated in NPPESMay 6, 2019
Details
- NPI
- 1104846575
- Entity type
- Individual (NPI-1)
- Name
- Mr. Randy A Hultberg
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 20, 2006
- Last updated
- May 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 804 | KY | Yes |
| 1041C0700X | Social Worker, Clinical | LSW0000000611 | TN |
Practice location
506 Hopkinsville StGreenville, KY 42345-1104
Phone 270-338-5211 · Fax 270-338-1624
Mailing address
Po Box 614Hopkinsville, KY 42241-0614
Phone 270-886-2205 · Fax 270-886-0392
Other practice locations
735 North Dr
Hopkinsville, KY 42240-2620
Hopkinsville, KY 42240-2620
Phone 270-886-5163 · Fax 270-886-5178
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