JEFFREY GORDON RANDALL LCSW/MSSW NPI 1780916577

NPI Information

  • NPI: 1780916577
  • Provider Name: JEFFREY GORDON RANDALL, LCSW/MSSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10 TOWER DR
    SUN PRAIRIE, WI
    ZIP 53590
  • Phone: (608) 825-3500

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NPI Details

Jeffrey Gordon Randall, LCSW/MSSW is a clinical social worker in Sun Prairie, WI with 14 years of experience. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Jeffrey Gordon Randall, LCSW/MSSW NPI is 1780916577. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10 TOWER DR
SUN PRAIRIE, WI
ZIP 53590-239
Phone: (608) 825-3500
Fax: (608) 824-4918

The NPI 1780916577 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychotherapy, 1 hour (HCPCS:90837)

The enumeration date for this NPI number is 2/4/2010 and was last updated on 9/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical8455-123WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11780916577MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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