Randi Davis, LPCIT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2935-226 Issued in WI

Practice address

719 W Main St
Wautoma, WI 54982-8503

Phone

(920) 787-7472

Fax

(920) 787-5458

NPI assigned

May 16, 2016

Last updated

May 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1659728038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W MAIN ST",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549828503",
            "telephone_number": "920-787-7472",
            "fax_number": "920-787-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W MAIN ST",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549828503",
            "telephone_number": "920-787-7472",
            "fax_number": "920-787-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RANDI",
        "credential": "LPCIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2935-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Waushara (Waushara County Clinical Services)
• County of Waushara (Waushara County Clinical Services)
• David N Crowther, MD
• Jennifer Dolores Culver, PHD
• Nathan L Daily, DDS
• Jordan Dietrich, DDS
• Kellen Dorff, PHARMD
• Katrina L Dorow Stevens, MA
• Paige Dorsey, APNP
• Veronica Eckstein, CSAC

• Mental Health Counselor in Wautoma, WI
• Providers in Wautoma, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.