Paul Stiles Randak

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

376787-3902 Issued in UT

Practice address

850 E 9400 S Ste 103
Sandy, UT 84094-4104

Phone

(801) 450-0199

Fax

(888) 503-2513

NPI assigned

May 9, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dream River Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sandy, UT
  • NPI 1346883634
  NPD Authorized official

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571529600000",
    "number": "1811486442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 E WOODCHUCK WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840932813",
            "telephone_number": "801-450-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E 9400 S STE 103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944104",
            "telephone_number": "801-450-0199",
            "fax_number": "888-503-2513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8420 S Wasatch Blvd",
            "address_purpose": "LOCATION",
            "city": "Cottonwood Heights",
            "state": "UT",
            "postal_code": "841216043",
            "country_code": "US",
            "telephone_number": "801-450-0199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7602 S Main St",
            "address_purpose": "LOCATION",
            "city": "Midvale",
            "state": "UT",
            "postal_code": "840477106",
            "country_code": "US",
            "telephone_number": "801-450-0199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDAK",
        "first_name": "PAUL",
        "middle_name": "STILES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2019-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "376787-6006",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "376787-3904",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "376787-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Ann Raines, RN
• Sarahi Guadalupe Ramirez Figueroa, AMFT
• Barbara Noelia Ramos-Cryer, LCSW
• John F. Ramsey, MD
• Ranaissance Ranch Outpatient Treatment (Brothers Keeper)
• Gregory J Randall, D.M.D.
• Veronica R Raniwala, MSW
• Amy E Rapp, MD
• Alyson Rose Rasmussen
• Aunalia Rasmussen, PHARMD

• Mental Health Counselor in Sandy, UT
• Providers in Sandy, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2019; 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.