Active NPI
Gwendolyn Randall
- Counselor
- Boston, MA
National Provider Identifier
1689020562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- S19312823
- Practice address
- 17 Court St
Boston, MA 02108-2601 - Phone
- (617) 371-1747
- NPI assigned
- May 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | S19312823 | MA | Primary |
Addresses
Primary practice location
17 Court St
Boston, MA 02108-2601
Mailing address
8 Hartwell St
Dorchester, MA 02121-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S19312823 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462838400000",
"number": "1689020562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 HARTWELL ST",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021212600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 COURT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021082601",
"telephone_number": "617-371-1747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "GWENDOLYN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-10",
"last_updated": "2016-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "S19312823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.