Benjamin D Randolph, CADCIII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

06-07-75U Issued in OR

Practice address

10600 SE McLoughlin Blvd Ste 207
Milwaukie, OR 97222-7428

Phone

(503) 901-1836

Fax

(503) 654-1852

NPI assigned

Apr 13, 2007

Last updated

Jan 21, 2019By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Oregon Trail Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Milwaukie, OR
  • NPI 1881010502
  NPD Authorized official
• Pacific Crest Trail Detox LLC

  • Substance Abuse Rehabilitation Facility
  • Milwaukie, OR
  • NPI 1043760838
  NPD (past) Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1225252612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 SE MCLOUGHLIN BLVD STE 207",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227428",
            "telephone_number": "503-901-1836",
            "fax_number": "503-654-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 SE MCLOUGHLIN BLVD STE 207",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227428",
            "telephone_number": "503-901-1836",
            "fax_number": "503-654-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "CADCIII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "06-07-75U",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sapna Ramanan, OTR
• Hunter Michelle Ramer, CSWA
• Chelsea Ramirez
• Mario Ramos
• Jasudha Ranabhat, NP
• Jennifer Randolph, CADC-II, CIP, CAI-II
• Keaton Randolph
• Renee' Lorena Raschke, BS, QMHA, CADC 1,
• Carol Rasmusen
• Jessica D Raymond, LMT

• Addiction (Substance Use Disorder) Counselor in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.