Ryan A Randall, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007248 Issued in VA

Practice address

1775 Forrestal Dr BLDG 33
Norfolk, VA 23551-0001

Phone

(757) 327-1076

NPI assigned

Nov 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1508401084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 MARINA WYND WAY",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284609104",
            "telephone_number": "757-327-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 FORRESTAL DR BLDG 33",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235510001",
            "telephone_number": "757-327-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "RYAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-08",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007248",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Coker Ramsey, PA-S
• Brandon Jermaine Rand
• Kristine B Rand, LCSW
• Amelia H. Randall, MD
• Kristopher Ward Randall, DO, MPH
• Neasa Randle, LCSW
• David M. Randolph, M.D.
• Rapid Transit
• James Carlos Rapley, M.D.
• Ashlea Azzopardi Rapp, LCSW

• Clinical Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.