Randi Jo Korell, MS LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

359 Issued in ID

Practice address

113 N Commercial
Emmett, ID 83617

Phone

(208) 398-8473

Fax

(208) 398-8311

NPI assigned

Feb 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 2

Other names 1

• Ms. Randi Jo Wenick Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073641510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 W HWY 52",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "83617",
            "telephone_number": "208-365-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N COMMERCIAL",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "83617",
            "telephone_number": "208-398-8473",
            "fax_number": "208-398-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORELL",
        "first_name": "RANDI",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "MS LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010152108",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Q7486",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDI",
            "last_name": "WENICK",
            "middle_name": "JO",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Peggy Knodel, LMFT
• Tara Landis, LCSW
• Danielle Dominique Langley
• Valerie Lawrence, RDN
• Lee Self MD PA
• Jackie Legg

• Professional Counselor in Emmett, ID
• Providers in Emmett, ID by specialty
• Professional Counselor in Idaho

• 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.