person
Randall Kenneth Shively, PHD,LICDC
Intellectual & Developmental Disabilities Psychologist in Columbus, Ohio
NPI 1235608084

Randall Kenneth Shively is a Intellectual & Developmental Disabilities Psychologist based in Columbus, OH and is specialized in Intellectual & Developmental Disabilities. Randall Kenneth Shively practices in Columbus, OH and has the professional credentials of PHD,LICDC. The NPI Number for Randall Kenneth Shively is 1235608084 and holds a License No. 975850 (Ohio).

The current practice location address for Randall Kenneth Shively is 2100 Stella Ct, Columbus, OH and can be reached out via phone at 614-252-8402 and via fax at 614-252-5326. You can also correspond with Randall Kenneth Shively through the mailing address at 2100 STELLA CT, COLUMBUS, OH - 43215-1011 (mailing address contact number: 614-252-8402).

Location: 2100 Stella Ct, Columbus, OH, 43215-1011
person
Provider Profile Details
NPI Number
1235608084
Provider Name
Randall Kenneth Shively
Credential
PHD,LICDC
Provider Entity Type
Individual
Gender
Male
Address
2100 Stella Ct, Columbus, OH, 43215-1011
Phone Number
614-252-8402
Fax Number
614-252-5326
Provider Enumeration Date
11/21/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2100 Stella Ct
City
State
Zip
43215-1011
Phone Number
614-252-8402
Fax Number
614-252-5326
person
Provider Business Mailing Address Details
Address
2100 Stella Ct
City
State
Zip
43215-1011
Phone Number
614-252-8402
Fax Number
614-252-5326
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
4374 (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Intellectual & Developmental Disabilities
Taxonomy
License No.
975850 (Ohio)
Definition
Definition to come...
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