Randall Ray Masterson, M.S., C.S.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

969847 Issued in IL

Practice address

302 S Kitchell Ave
Suite a
Olney, IL 62450-1500

Phone

(618) 392-2725

Fax

(866) 302-0227

NPI assigned

Jan 26, 2012

Last updated

Jan 26, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Randall Ray Masterson

  dba Associated Psychologists

  • Clinical Psychologist
  • Olney, IL
  • NPI 1659550879
  Authorized official Same address or phone

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1790056489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S KITCHELL AVE",
            "address_2": "SUITE A",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501500",
            "telephone_number": "618-392-2725",
            "fax_number": "866-302-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S KITCHELL AVE",
            "address_2": "SUITE A",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501500",
            "telephone_number": "618-392-2725",
            "fax_number": "866-302-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "RANDALL",
        "middle_name": "RAY",
        "credential": "M.S., C.S.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "969847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Olney, IL
• Providers in Olney, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.