Individual provider Active NPI

Randall McBride, LCSW

  • Clinical Social Worker
  • Glendale, AZ
National Provider Identifier
1174790844
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-13096 Issued in AZ
Practice address
6833 W Bell Rd
Glendale, AZ 85308-8453
Phone
(623) 878-2037
Fax
(623) 878-2302
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-13096 AZ Primary

Addresses

Primary practice location

6833 W Bell Rd
Glendale, AZ 85308-8453

Mailing address

6833 W Bell Rd
Glendale, AZ 85308-8453
Phone (623) 878-2037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2017 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-13096AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1174790844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6833 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088453",
            "telephone_number": "623-878-2037",
            "fax_number": "623-878-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6833 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088453",
            "telephone_number": "623-878-2037",
            "fax_number": "623-878-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "RANDALL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-13096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.