Randall Lee Slavens, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1959 Issued in ND

Practice address

151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715

Phone

(701) 795-3000

Fax

(701) 795-3050

NPI assigned

Jun 11, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225070865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S 4TH ST",
            "address_2": "SUITE 401",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014715",
            "telephone_number": "701-795-3000",
            "fax_number": "701-795-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S 4TH ST",
            "address_2": "SUITE 401",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014715",
            "telephone_number": "701-795-3000",
            "fax_number": "701-795-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVENS",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "1959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054519",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN PROVIDER NUMBER",
            "identifier": "73B47SL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND PROVIDER NUMBER",
            "identifier": "020530",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Skinner
• Jessica Skjolden, MD
• Heather Skogen, LBSW
• Ashley Skonieczny
• Kalvin Slaubaugh
• Sleepeasy Therapeutics Inc
• Allison Slick, PT
• Lora Lee Sloan McArthur, PH.D.
• Jill Kathryn Slocum, PT
• William Ira Slocum, PT

• Clinical Social Worker in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.