Active NPI
Randy Allen Dymond, M.S., M.P.A.
- Clinical Social Worker
- Marcy, NY
National Provider Identifier
1407033640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R-27930-1
- Practice address
- Central New York Psychiatric Center, Old River Road
Marcy, NY 13403 - Phone
- (315) 765-3647
- Fax
- (315) 765-3659
- NPI assigned
- Jan 30, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R-27930-1 | NY | Primary |
Addresses
Primary practice location
Central New York Psychiatric Center, Old River Road
Marcy, NY 13403
Mailing address
PO Box 300
Central New York Psychiatric Center, Old River Road
Marcy, NY 13403
Phone (315) 765-3647
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-27930-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1407033640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 300",
"address_2": "CENTRAL NEW YORK PSYCHIATRIC CENTER, OLD RIVER ROAD",
"city": "MARCY",
"state": "NY",
"postal_code": "13403",
"telephone_number": "315-765-3647",
"fax_number": "315-765-3659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CENTRAL NEW YORK PSYCHIATRIC CENTER, OLD RIVER ROAD",
"city": "MARCY",
"state": "NY",
"postal_code": "13403",
"telephone_number": "315-765-3647",
"fax_number": "315-765-3659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYMOND",
"first_name": "RANDY",
"middle_name": "ALLEN",
"credential": "M.S., M.P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-30",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R-27930-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marcy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.