Active NPI
Elise Randall
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1740960665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 126963
- Practice address
- 1201 Harmon PL Ste 103
Minneapolis, MN 55403-2045 - Phone
- (651) 319-6210
- NPI assigned
- Jul 25, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 126963 | IA | Primary |
Addresses
Primary practice location
1201 Harmon PL Ste 103
Minneapolis, MN 55403-2045
Mailing address
7116 W 113TH St
Minneapolis, MN 55438-2448
Phone (612) 559-2729
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 |
|---|---|---|---|
| 126963 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1740960665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7116 W 113TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554382448",
"telephone_number": "612-559-2729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 HARMON PL STE 103",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554032045",
"telephone_number": "651-319-6210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "ELISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-25",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "126963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.