Individual provider Active NPI

Caryn Randall, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1871306837
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11085 Issued in OR
Practice address
9155 SW Barnes Rd Ste 634
Portland, OR 97225-6632
Phone
(503) 216-9142
NPI assigned
Jan 31, 2025
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L11085 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 634
Portland, OR 97225-6632

Mailing address

9155 SW Barnes Rd Ste 634
Portland, OR 97225-6632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20250305001233 OR Practitioner - Clinical Social Worker 4789105842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 27, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 27, 2025 Accepting new patients

Locations

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9155 SW Barnes Rd
Ste 634
Portland, OR 97225
Phone (503) 216-6662

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1871306837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 634",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 634",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256632",
            "telephone_number": "503-216-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "CARYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.