Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Randall

Individual provider Clinical Social Worker · NPI 1508526773

Ethan Randall is a Clinical Social Worker in Tahlequah, Oklahoma. Practices as a sole proprietor and works from 2 locations. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2021
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

308 E Downing St
Tahlequah, OK 74464-3014
Phone: (918) 931-3995
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 217 N Water Ave, Tahlequah, OK 74464-2825 — (888) 692-6590

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 8189 (OK)

Record details

NPI number1508526773
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 29, 2021
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024
Mailing address6947 N 460 Rd, Hulbert, OK 74441-3250

Other providers in Tahlequah