NPIMap

Organization Active NPI

Randall Ray Masterson

Doing business as Associated Psychologists

  • Clinical Psychologist
  • Olney, IL
National Provider Identifier
1659550879
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.006994 Issued in IL
Legal business name
RANDALL RAY MASTERSON
Doing business as
Associated Psychologists
Practice address
302 S Kitchell Ave
Olney, IL 62450-1500
Phone
(618) 392-2725
NPI assigned
Oct 24, 2007
Last updated
Feb 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Randall R Masterson, M.S.C.S.P.NPI 1790056489
Title
Associate
Phone
(618) 392-2725

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.006994 IL Primary
School Psychologist 103TS0200X 969847 IL

Addresses

Primary practice location

302 S Kitchell Ave
Olney, IL 62450-1500

Mailing address

302 S Kitchell Ave
Olney, IL 62450-1500
Phone (618) 392-2725

Other names 1

  • Associated Psychologists Doing business as

National Provider Directory

National Provider Directory

Locations

302 S Kitchell Ave
Olney, IL 62450
Phone (618) 392-2725

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1659550879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S KITCHELL AVE",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501500",
            "telephone_number": "618-392-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S KITCHELL AVE",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501500",
            "telephone_number": "618-392-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL RAY MASTERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "618-392-2725",
        "authorized_official_credential": "M.S.C.S.P."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.006994",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "969847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Psychologists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.