Randall Crouch, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH10076 Issued in FL

Practice address

4055 Tamiami TRL
Port Charlotte, FL 33952-9212

Phone

(941) 276-7889

Fax

(941) 249-5039

NPI assigned

Oct 22, 2009

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

Opted out of Medicare

Yes, effective Oct 10, 2024 through Oct 10, 2026

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.

• Real Therapy Solutions, Inc

  • Mental Health Counselor
  • Port Charlotte, FL
  • NPI 1184174286
  NPD Authorized official
• Strongmind, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Charlotte, FL
  • NPI 1770077810
  NPD (past)

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1982930137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529212",
            "telephone_number": "941-276-7889",
            "fax_number": "941-249-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529212",
            "telephone_number": "941-276-7889",
            "fax_number": "941-249-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "RANDALL",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy L Criss, DO
• Patricia Ann Crist, OTR/L
• Carissa Crites
• Erica Cromwell
• Kristina Crook
• Stephanie Crum, PA
• Edgar Joel Cruz Crispin, DNP, APRN
• Karina Cruz, ARNP
• Daniel Cueto, M.D.
• Kathleen Cullen, PA

• Mental Health Counselor in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.