JEFFREY GORDON RANDALL (NPI# 1780916577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780916577 |
| Entity Type | Individual |
| Full Name | JEFFREY GORDON RANDALL |
| Credential | LCSW/MSSW |
| Practice Address |
4131 Meridian Dr Windsor WI 53598-9699 |
| Mailing Address |
7974 Uw Health Ct Middleton WI 53562-5531 |
| Practice Telephone | 6088463741 |
| Practice Fax Number | 6088467898 |
| Mailing Telephone | 6088295485 |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2018-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
8455-123 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871926816 | Jeffrey Scott Randall | Licensed Practical Nurse | 2230 W Calle Del Sol, Phoenix, AZ 85085-7044 | 2013-08-13 |
| 1376688796 | Jeffrey Dwayne Randall | Counselor | 501 Highway 90 E, Little River, SC 29566-9261 | 2007-02-21 |
| 1952469967 | Jeffrey Blaine Randall | Chiropractor | 434 S Kiwanis Ave, Suite A, Sioux Falls, SD 57104-3710 | 2006-12-04 |
| 1598716045 | Jeffrey Randall | Physical Therapist | 9088 Ridgeline Blvd Ste 106, Highlands Ranch, CO 80129-2380 | 2006-05-12 |
| 1730707480 | Jeffrey Blaine Randall | Counselor | 4867 Urbana Rd, Springfield, OH 45502 | 2020-07-09 |
| 1841754066 | Jeffrey Randall | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2019-01-23 |
| 1053782656 | Jeffrey Randall | Social Worker | 3500 Ne Mlk Blvd Ste 200, Portland, OR 97212-2093 | 2015-10-08 |
| 1467410811 | Jeffrey C Randall | Orthopaedic Surgery | 1112 W 6th St, Ste 124, Lawrence, KS 66044-2215 | 2006-05-03 |
| 1720046295 | Jeffrey Blaine Randall | Neurological Surgery | 20055 Lake Chabot Rd, # 110, Castro Valley, CA 94546 | 2006-05-03 |
| Street Address |
4131 MERIDIAN DR |
| City | WINDSOR |
| State | WI |
| Zip Code | 53598-9699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528028701 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 4131 Meridian Dr, Windsor, WI 53598-0000 | 2006-03-23 |
| 1841797230 | Gretchen Straus | Counselor | 4131 Meridian Dr, Windsor, WI 53598-9699 | 2018-04-11 |
| 1437513843 | Benjamin D Traun | Family Medicine | 4131 Meridian Dr, Windsor, WI 53598-9699 | 2016-04-12 |
| 1528300688 | Sreevalli Atluru | Family Medicine | 4131 Meridian Dr, Windsor, WI 53598-9699 | 2013-03-26 |
| 1306112172 | Bethany Morehouse Howlett | Family Medicine | 4131 Meridian Dr, Windsor, WI 53598-9699 | 2012-03-27 |
| 1235406539 | Benjamin R Kempfer | Physician Assistant | 4131 Meridian Dr, Windsor, WI 53598-9699 | 2011-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518127877 | Edward James Saur | Dentist | 6597 Lake Road, Windsor, WI 53598 | 2008-06-11 |
| 1356564249 | S A Khan | Dentist | 6729 Lake Road, Windsor, WI 53598 | 2007-04-10 |
| 1790799302 | Tara Marie Bell | Dentist | 6729 Lake Rd, Windsor, WI 53598 | 2006-07-28 |
| 1750359832 | Philip R Carlson | Radiology | 6696 Wolf Hollow Rd, Windsor, WI 53598 | 2006-03-14 |
| 1003023367 | Windsor Family Dental, S.c. | Dentist | 6729 Lake Road, Windsor, WI 53598-0000 | 2007-05-17 |
| 1962626077 | Scott Howard Nettum | Dentist | 6729 Lake Road, Windsor, WI 53598-0000 | 2007-04-12 |
| 1043798846 | Toni Boegel | Licensed Practical Nurse | 6648 Scattergood Ln, Windsor, WI 53598-2504 | 2018-08-02 |
| 1144593930 | Forward Health | Skilled Nursing Facility | 6784 Bootmaker Way, Windsor, WI 53598-9630 | 2012-02-09 |
| 1801160114 | Kristina Marie Kurtz | Licensed Practical Nurse | 6784 Bootmaker Way, Windsor, WI 53598-9630 | 2012-03-05 |
| 1841613395 | Keith Klinger | Physical Therapy Assistant | 6522 Lake Rd Apt 4, Windsor, WI 53598-9651 | 2014-02-03 |
| Find all providers in zip 53598 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013538149 | Amy Joy Parent | Social Worker | 13 North Cir, Windsor, CT 06095-2420 | 2020-04-29 |
| 1518443027 | Professional Institute for Clinical Service, LLC | Social Worker | 360 Bloomfield Ave Ste 306, Windsor, CT 06095-2700 | 2018-07-17 |
| 1417409731 | Crystal Noel Meredith | Social Worker | 385 Antora Ct, Windsor, CO 80550-3239 | 2016-11-03 |
| 1063963072 | Kathryn Jacobs | Social Worker | 111 Cricket Ct, Windsor, CA 95492-7950 | 2016-10-14 |
| 1063873875 | Cassandra Williams | Social Worker | 2189 Grain Bin Ct, Windsor, CO 80550-3427 | 2016-03-08 |
| 1134588403 | Anne Marie Kelly | Social Worker | 82 State St, Windsor, VT 05089-1276 | 2016-02-16 |
| 1588050272 | Lauren Elizabeth Maloney | Social Worker | 1 Lang Rd, Windsor, CT 06095-1514 | 2015-04-09 |
| 1245649128 | Terraine Jamison | Social Worker | 581 Bloomfield Ave, Windsor, CT 06095-6095 | 2014-08-05 |
| 1154752673 | Tabitha A Scott | Social Worker | 9291 Old Redwood Hwy # 500, Windsor, CA 95492-8089 | 2013-12-09 |
| 1396187928 | Donna Vibes | Social Worker | 34 Lighthouse Hill Rd, Windsor, CT 06095-1210 | 2013-07-24 |
| Find all providers in WINDSOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.