William George Randle Jr., MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002207 Issued in MO

Practice address

4411 N Newstead Ave
Saint Louis, MO 63115-2534

Phone

(314) 531-1770

Fax

(314) 381-6796

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Betty Jean Kerr People'S Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1194797787
  NPD (past)
• Betty Jean Kerr People'S Health Centers

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1215692348
  NPD (past)
• Betty Jean Kerr People'S Health Centers

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1679604318
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023221744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 CAMDEN CT",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631301914",
            "telephone_number": "314-531-1770",
            "fax_number": "314-381-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N NEWSTEAD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631152534",
            "telephone_number": "314-531-1770",
            "fax_number": "314-381-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "WILLIAM",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "002207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORKER",
            "identifier": "NO.002207",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saboor Ejaz Randhawa, MBBS
• Sandeep Randhawa, M.D.
• Dionne Randle
• Laconte Randle, NURSE PRACTITIONER
• Nanette Randle
• Mary M. Randlett, PH.D.
• Bernard C Randolph Jr., M.D.
• Bethany N Randolph
• Jacqueline Randolph
• Katherine M Randolph, LPC, NCC

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.