Jennifer Latrice Randle

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.018697 Issued in IL

Practice address

745 McClintock Dr Ste 100
Burr Ridge, IL 60527-0863

Phone

(708) 347-1776

NPI assigned

Jun 16, 2023

Sex

Female

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

State licenses

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1285319376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16W525 MOCKINGBIRD LN APT 203",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605276623",
            "telephone_number": "708-347-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 MCCLINTOCK DR STE 100",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270863",
            "telephone_number": "708-347-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "JENNIFER",
        "middle_name": "LATRICE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.018697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rana Raddawi, PHD
• Susan Marie Radtke, PH.D.
• Jaishankar Raman, MBBS, MMED, FRACS, P
• Ram L. Ramani, M.D.
• Elizabeth Ramirez
• Kathleen B Raschka, M.D.
• Raad Rashan, MD
• Lauren L Rasor, CCC SLP/L
• Nancy Reau, MD
• Reb Counseling LLC

• Mental Health Counselor in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.