Deborah Randolph, LCSW, PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1766 Issued in OK

Legal business name

DEBORAH RANDOLPH, LCSW, PC

Practice address

1441 NW 150TH St
Edmond, OK 73013-1305

Phone

(405) 509-1384

Fax

(405) 563-9416

NPI assigned

Aug 1, 2011

Organization subpart

No

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

Authorized official

Name

Deborah Kay Randolph, LCSW

Title

President

Phone

(405) 509-1384

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1306124961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NW 150TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131305",
            "telephone_number": "405-509-1384",
            "fax_number": "405-563-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 NW 150TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131305",
            "telephone_number": "405-509-1384",
            "fax_number": "405-563-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH RANDOLPH, LCSW, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-509-1384",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "1766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deer Creek Family Healthcare and Wellness Clinic LLC

• Clinical Social Worker in Edmond, OK
• Providers in Edmond, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.