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Randall Crisco, PRSS
Peer Specialist in Princeton, West Virginia
NPI 1306523881

Randall Crisco is a Peer Specialist based in Princeton, WV. Randall Crisco practices in Princeton, WV and has the professional credentials of PRSS. The NPI Number for Randall Crisco is 1306523881 and holds a License No. 23-9121 (West Virginia).

The current practice location address for Randall Crisco is 200 12Th Street Ext, Princeton, WV and can be reached out via phone at 304-425-9541.

Location: 200 12Th Street Ext, Princeton, WV, 24740-2329
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306523881
Provider Name
Randall Crisco
Credential
PRSS
Provider Entity Type
Individual
Gender
Male
Address
200 12Th Street Ext, Princeton, WV, 24740-2329
Phone Number
304-425-9541
Fax Number
Provider Enumeration Date
06/28/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
200 12Th Street Ext
City
Princeton
State
West Virginia
Zip
24740-2329
Phone Number
304-425-9541
Fax Number
person
Provider Business Mailing Address Details
Address
200 12Th Street Ext
City
Princeton
State
West Virginia
Zip
24740-2329
Phone Number
304-425-9541
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
23-9121 (West Virginia)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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