Randy Lee Wall, LPC, NCC

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

License

5048 Issued in NC

Practice address

2560 Cold Springs Rd E
Concord, NC 28025-8004

Phone

(704) 789-3975

NPI assigned

Mar 14, 2007

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

Medicare fee-for-service enrollment

Enrolled in NC

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

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700919099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 COLD SPRINGS RD E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280258004",
            "telephone_number": "704-789-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 COLD SPRINGS RD E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280258004",
            "telephone_number": "704-789-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "RANDY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NC",
            "license": "5048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Walker, DDS
• Walkers Home Care
• Bonnie L Wall
• Donna W Wall, CRNA
• James Wall, MD
• Caroline Wallace
• Jakeyla Wallace
• Jennifer Leigh Wallace, PHARM D
• Tamera Waller-Drye
• Carly Lynne Waller, CNM

• Pastoral Counselor in Concord, NC
• Providers in Concord, NC by specialty
• Pastoral Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.