Active NPI
Randolph Will Severson, PHD
- Professional Counselor
- Dallas, TX
National Provider Identifier
1033269741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3216
- Practice address
- 5025 North Central Expressway
#3026
Dallas, TX 75205-3447 - Phone
- (214) 521-4560
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3216 | TX | Primary |
| Marriage & Family Therapist | 106H00000X | 000329021428 | TX |
Addresses
Primary practice location
5025 North Central Expressway
#3026
Dallas, TX 75205-3447
Mailing address
5025 North Central Expressway
#3026
Dallas, TX 75205-3447
Phone (214) 521-4560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6110LC | Other | BLUE CROSS BLUE SHIELD PR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000329021428 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1033269741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5025 NORTH CENTRAL EXPRESSWAY",
"address_2": "#3026",
"city": "DALLAS",
"state": "TX",
"postal_code": "752053447",
"telephone_number": "214-521-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5025 NORTH CENTRAL EXPRESSWAY",
"address_2": "#3026",
"city": "DALLAS",
"state": "TX",
"postal_code": "752053447",
"telephone_number": "214-521-4560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERSON",
"first_name": "RANDOLPH",
"middle_name": "WILL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "3216",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "000329021428",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD PR",
"identifier": "6110LC",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.