Ida Joyce Randall

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1745-01 Issued in CO

Practice address

2860 S Circle Dr Ste 220
Colorado Springs, CO 80906-4133

Phone

(719) 634-1240

Fax

(719) 540-0174

NPI assigned

Jul 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1184854606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064133",
            "telephone_number": "719-634-1240",
            "fax_number": "719-540-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064133",
            "telephone_number": "719-634-1240",
            "fax_number": "719-540-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "IDA",
        "middle_name": "JOYCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "1745-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lawrence Rand
• Patricia J. Rand, M.D.
• Abigail Joy Randall, LPC
• Amy Margaret Randall, PA-C
• Christopher Randall, PA-C
• Jennifer Lynn Randall
• Kimberly Randall, RN
• Megan Elizabeth Randall, LCSW
• Tina Kay Randall
• Randel B. Wing Dom PC

• Addiction (Substance Use Disorder) Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.