Randolph Laird Clark, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007681A Issued in IN

Practice address

554 Pit Rd
Brownsburg, IN 46112-9555

Phone

(317) 742-9400

Fax

(317) 742-9414

NPI assigned

Sep 9, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rclark7794@direct.eskenazihealth.edu

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

• Rediscover Counseling, LLC

  • Clinical Social Worker
  • Brownsburg, IN
  • NPI 1306689138
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1245665363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 PIT RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129555",
            "telephone_number": "317-742-9400",
            "fax_number": "317-742-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 PIT RD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129555",
            "telephone_number": "317-742-9400",
            "fax_number": "317-742-9414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 E US Highway 36",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461238923",
            "country_code": "US",
            "telephone_number": "888-714-1927",
            "fax_number": "317-272-0807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 N Illinois St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021316",
            "country_code": "US",
            "telephone_number": "317-554-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RANDOLPH",
        "middle_name": "LAIRD",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-09",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007681A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rclark7794@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "1700 N Illinois St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Circle City Pharmacy, LLC
• Circle City Pharmacy, LLC
• Brittney Nicole Clark, LMHC
• Cecelia Clark
• Hollie Clark
• Roxanna Clay, RN
• Makenzie Mae Clements, MS CF SLP
• Emma Cline, M.A., CCC-SLP
• Madilyn B Cline, RBT
• Maddison Cody

• Clinical Social Worker in Brownsburg, IN
• Providers in Brownsburg, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.