Active NPI
Wendy Reed Randall, L.C.A.S.
- Addiction (Substance Use Disorder) Counselor
- Wake Forest, NC
National Provider Identifier
1396976783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1492
- Practice address
- 6029 Clapton Dr
Wake Forest, NC 27587-4263 - Phone
- (262) 960-4739
- NPI assigned
- Aug 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1492 | NC | Primary |
Addresses
Primary practice location
6029 Clapton Dr
Wake Forest, NC 27587-4263
Mailing address
6029 Clapton Dr
Wake Forest, NC 27587-4263
Phone (262) 960-4739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1492 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349308800000",
"number": "1396976783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6029 CLAPTON DR",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275874263",
"telephone_number": "262-960-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6029 CLAPTON DR",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275874263",
"telephone_number": "262-960-4739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "WENDY",
"middle_name": "REED",
"name_prefix": "Mrs.",
"credential": "L.C.A.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-03",
"last_updated": "2012-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.