Individual provider Active NPI

Whitney Ann Edwards Randall, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1770857773
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019505 Issued in NY
Practice address
2920 Broadway, Mail Code 2606
Alfred Lerner Hall, 8TH Floor
New York, NY 10027-7164
Phone
(212) 854-2878
NPI assigned
Mar 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 019505 NY Primary
Clinical Psychologist 103TC0700X 9453 MA

Addresses

Primary practice location

2920 Broadway, Mail Code 2606
Alfred Lerner Hall, 8TH Floor
New York, NY 10027-7164

Mailing address

2920 Broadway, Mail Code 2606
Alfred Lerner Hall, 8TH Floor
New York, NY 10027-7164
Phone (212) 854-2878

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

LicenseStateTypeSpecialty
9453MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1770857773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 BROADWAY, MAIL CODE 2606",
            "address_2": "ALFRED LERNER HALL, 8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277164",
            "telephone_number": "212-854-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 BROADWAY, MAIL CODE 2606",
            "address_2": "ALFRED LERNER HALL, 8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277164",
            "telephone_number": "212-854-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "WHITNEY",
        "middle_name": "ANN EDWARDS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019505",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.