Individual provider · Type 1 NPI

Randyl Shane Chase

Addiction (Substance Use Disorder) Counselor · Canton, NY

NPI number 1689232860 Active

Practice location

80 State Highway 310 Ste 1
Canton, NY 13617-1493

Call (315) 386-2189 Map

Mailing address

136 Wilson St
Gouverneur, NY 13642-3270

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X35354 (NY)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1689232860

Randyl Shane Chase's National Provider Identifier is 1689232860, issued on Jun 3, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Canton, NY. The record was last updated on Jun 3, 2019.