NPIMap

Organization Active NPI

Randolph Behavioral Health Services, Inc.

  • Community/Behavioral Health Agency
  • Randolph, MA
National Provider Identifier
1275079097
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RANDOLPH BEHAVIORAL HEALTH SERVICES, INC.
Practice address
21 Mazzeo Dr Ste 102
Randolph, MA 02368-3448
Phone
(781) 885-7530
NPI assigned
Jan 18, 2017
Last updated
May 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Daphne Claudomir, LMHCNPI 1063714384
Title
President
Phone
(781) 885-7530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Group Psychotherapy Psychologist 103TP2701X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

21 Mazzeo Dr Ste 102
Randolph, MA 02368-3448

Mailing address

PO Box 4414
Boynton Beach, FL 33424-4414
Phone (781) 885-7530

Other practice location 1

5700 Lake Worth Rd Ste 106
Greenacres, FL 33463-3213
Phone (561) 727-8635

Other practice location 2

4 Frank Leary Way Unit 4
Randolph, MA 02368-4512
Phone (781) 885-7530

Other practice location 3

1500 Gateway Blvd Ste 220
Boynton Beach, FL 33426-7233
Phone (781) 437-7507

Other practice location 4

966 Park St Ste A2
Stoughton, MA 02072-3664
Phone (781) 885-7530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190320001560 MA Part B Supplier - Clinic/Group Practice 9436499944 Receives reassigned benefits from 3 practitioners
Practice locations: Randolph, MA
O20231214002417 FL Part B Supplier - Clinic/Group Practice 9436499944 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Greenacres, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Randolph Behavioral Health Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

21 Mazzeo Dr
Ste 102
Randolph, MA 02368
Phone (781) 437-7507

4 Frank Leary Way
Unit 4
Randolph, MA 02368
Phone (781) 885-7530

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1275079097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4414",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334244414",
            "telephone_number": "781-885-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MAZZEO DR STE 102",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683448",
            "telephone_number": "781-885-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Lake Worth Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Greenacres",
            "state": "FL",
            "postal_code": "334633213",
            "country_code": "US",
            "telephone_number": "561-727-8635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Frank Leary Way Unit 4",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "MA",
            "postal_code": "023684512",
            "country_code": "US",
            "telephone_number": "781-885-7530",
            "fax_number": "855-284-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Gateway Blvd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334267233",
            "country_code": "US",
            "telephone_number": "781-437-7507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "966 Park St Ste A2",
            "address_purpose": "LOCATION",
            "city": "Stoughton",
            "state": "MA",
            "postal_code": "020723664",
            "country_code": "US",
            "telephone_number": "781-885-7530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RANDOLPH BEHAVIORAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "CLAUDOMIR",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-885-7530",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.