Randolph Paul Andersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149027573 Issued in IL

Practice address

128 S County Farm Rd Ste C
Wheaton, IL 60187-2400

Phone

(630) 447-8818

NPI assigned

Jun 11, 2015

Last updated

Sep 5, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX, CO, IL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychiatry of Texas PLLCGroup PAC ID 0345573598, 418 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Psychiatry of Texas PLLC

  dba Psychplus Associates

  • Psychiatry Physician
  • Houston, TX
  • NPI 1013476027

  CO, IL

  Medicare reassignment Care Compare group NPD
• Community Reach Center, Inc

  • Community/Behavioral Health Agency
  • Thornton, CO
  • NPI 1316906886
  Medicare reassignment NPD
• Psychplus Medical Associates, PLLC

  • Family Medicine Physician
  • Houston, TX
  • NPI 1558118026

  CO, IL

  Medicare reassignment NPD
• Panahi Counseling, PC

  • Professional Counselor
  • Wheaton, IL
  • NPI 1760069751
  NPD
• Community Reach Center, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Broomfield, CO
  • NPI 1841887056
  NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1083095392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 S COUNTY FARM RD STE C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872400",
            "telephone_number": "630-447-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S COUNTY FARM RD STE C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872400",
            "telephone_number": "630-447-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "RANDOLPH",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• American Drug Stores LLC (Osco Drug #3230)
• Alkaben Dwijen Amin, PHARMD
• Diane Amstutz, PHD.
• Donna Ruth Amstutz, PHD
• Sonika Anand, MD
• Shannon Andersen
• Susan J Anderson-Nelson, M.D.
• Africa C Anderson, ED.S. ATP, RN
• Cindy Anderson
• Dionna Anderson

• Clinical Social Worker in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.