Provider Demographics
NPI:1487706107
Name:SOLAND, RANDALL JOSEPH (LCPC)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:JOSEPH
Last Name:SOLAND
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 SOUTH SIXTH STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-0406
Mailing Address - Country:US
Mailing Address - Phone:217-523-3143
Mailing Address - Fax:217-523-7695
Practice Address - Street 1:1124 SOUTH SIXTH STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-0406
Practice Address - Country:US
Practice Address - Phone:217-523-3143
Practice Address - Fax:217-523-7695
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL000198101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional