Randall R Melvin, LCSW BCD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC4787 Issued in ME

Practice address

465 Congress St
Suite 700
Portland, ME 04101-3528

Phone

(207) 773-2828

Fax

(207) 761-8150

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• R Melvin Counseling LLC

  • Clinical Social Worker
  • Portland, ME
  • NPI 1265972749
  Medicare reassignment NPD Authorized official
• Claire Oppenheim LLC

  • Clinical Social Worker
  • Portland, ME
  • NPI 1144466152
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1669495974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 CONGRESS ST",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013528",
            "telephone_number": "207-773-2828",
            "fax_number": "207-761-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 CONGRESS ST",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013528",
            "telephone_number": "207-773-2828",
            "fax_number": "207-761-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "RANDALL",
        "middle_name": "R",
        "credential": "LCSW BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "040317",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd P Mellin, DMD
• Kaitlyn Beverly Mellon
• Joseph Melnick, PH.D.
• Spencer Melnick, L.C.S.W.
• Mary T Melquist, PHD
• Lilah Diane Melzer, DO
• Shaena Menagh
• Ashley K Mendes, LCSW
• Rolando Bryan Aberin Mendiola, PSY.D.
• Rachelle Nichole Mendola, DO

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.