Mickala Randby, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MICKALA RANDBY, PLLC

Practice address

1310 Prairie Dr
Algonquin, IL 60102-4251

Phone

(708) 328-8461

NPI assigned

Mar 13, 2024

Organization subpart

No

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

Authorized official

Name

Mickala Randby, LCSWNPI 1437859733

Title

Owner

Phone

(708) 328-8461

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mickala Taylor Randby

  • Social Worker
  • Skokie, IL
  • NPI 1437859733
  NPD Authorized official

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1912766965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 PRAIRIE DR",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024251",
            "telephone_number": "708-328-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PRAIRIE DR",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024251",
            "telephone_number": "708-328-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICKALA RANDBY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "RANDBY",
        "authorized_official_first_name": "MICKALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-328-8461",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Algonquin, IL
• Providers in Algonquin, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.