Heather W. Randolph, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1491 Issued in KY

Practice address

7511 New Lagrange Rd
Louisville, KY 40222-4859

Phone

(502) 423-1151

Fax

(502) 423-1748

NPI assigned

May 21, 2008

Last updated

Apr 15, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Kentuckiana Psychological Associates PLLC

  dba BrainDocs

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1669327151
  Medicare reassignment
• Optum Behavioral Care of North Carolina, PC

  dba Edelson and Associates of Kentucky

  • Counseling Psychologist
  • Lexington, KY
  • NPI 1689449910
  Medicare reassignment

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1861659302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 NEW LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224859",
            "telephone_number": "502-423-1151",
            "fax_number": "502-423-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 NEW LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224859",
            "telephone_number": "502-423-1151",
            "fax_number": "502-423-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "HEATHER",
        "middle_name": "W.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Randall, PTA
• Clinton Randall
• Lavonda Nicole Randle, MSN, APRN, ACNPC-AG
• Daniel Randolph, RPH.
• Dave Randolph
• Jeremy Randolph, P.T.
• Michelle D Randolph, MSPT
• Random House Community Living Inc
• Ashley Lynn Raney
• Rama S Ranga, R.PH., PH.D

• Clinical Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.