Individual provider Active NPI

Jamie Randle, B.A

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1679997449
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1505 N Chestnut Ave
Fresno, CA 93703-4504
Phone
(559) 265-4800
NPI assigned
Feb 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1505 N Chestnut Ave
Fresno, CA 93703-4504

Mailing address

5252 N Valentine Ave Apt 203
Fresno, CA 93711-4026
Phone (559) 381-7220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220201002162 TX Practitioner - Clinical Psychologist 4183017890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ar Psychological Services PLLCGroup PAC ID 2668616434, 2 clinicians

Practice addresses (Care Compare)

191 W Southlake Blvd
Suite 100 Ar Psychological Services
Southlake, TX 76092-7031
Phone (817) 488-0502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Ar Psychological Services PLLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

191 W Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 381-9650

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1679997449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 N VALENTINE AVE APT 203",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937114026",
            "telephone_number": "559-381-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 N CHESTNUT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937034504",
            "telephone_number": "559-265-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "JAMIE",
        "credential": "B.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.