Active NPI
Randi L Klaire-Jefferson, MA, ATR
- Art Therapist
- Port St Lucie, FL
National Provider Identifier
1740904226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 86-069
- Practice address
- 537 SW Dauphin Ave
Port St Lucie, FL 34953-5854 - Phone
- (423) 341-3356
- NPI assigned
- Sep 28, 2022
- Last updated
- Sep 28, 2022
- 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 |
|---|---|---|---|---|
| Art Therapist | 221700000X | 86-069 | NY | Primary |
Addresses
Primary practice location
537 SW Dauphin Ave
Port St Lucie, FL 34953-5854
Mailing address
537 SW Dauphin Ave
Port St Lucie, FL 34953-5854
Phone (423) 341-3356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K462-732-55-629-0 | Other | FL | DRIVERS LICENSE |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86-069 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1740904226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 SW DAUPHIN AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349535854",
"telephone_number": "423-341-3356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 SW DAUPHIN AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349535854",
"telephone_number": "423-341-3356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLAIRE-JEFFERSON",
"first_name": "RANDI",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MA, ATR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-28",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Art Therapist",
"state": "NY",
"license": "86-069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "K462-732-55-629-0",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.