Mandy Randall, LPC, LCDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79060 Issued in TX

Practice address

18018 Overlook Loop
Suite 105, PMB 1029
San Antonio, TX 78259-1883

Phone

(210) 595-9158

Fax

(844) 832-4701

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mandy Marin Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavors Health Services BoardGroup PAC ID 4587001987, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Endeavors Health Services Board

  • Specialist
  • San Antonio, TX
  • NPI 1457038721

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Wild Courage Counseling, PLLC

  • Adult Mental Health Clinic/Center
  • San Antonio, TX
  • NPI 1033076690
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1316523749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18018 OVERLOOK LOOP",
            "address_2": "SUITE 105, PMB 1029",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78259",
            "telephone_number": "210-595-9158",
            "fax_number": "844-832-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18018 OVERLOOK LOOP",
            "address_2": "SUITE 105, PMB 1029",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591883",
            "telephone_number": "210-595-9158",
            "fax_number": "844-832-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "MANDY",
        "credential": "LPC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15052",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79060",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "79060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "MARIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Randall L. Whitten, DDS, PA
• Randall Schulze & Associates PC
• Charles W Randall, MD
• Denise Lorraine Randall, PHARM.D., R.PH.
• Kaylyn Pratt Randall, PA
• Tyler J Randall, M.D.
• Randdolf Physicians PLLC
• Abigail Randecker, RD, LD
• Matthew Thomas Randel
• Angelina Amelii Randez

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.