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JEFFREY RANDALL
NPI 1053782656
Social Worker - Clinical in Portland, OR

Active since October 08, 2015Opted out of Medicare · through Apr 1, 2028
3500 NE MLK BLVD STE 200, PORTLAND, OR 97212(503) 327-8205 Get Directions Write a Review

NPPES record last updated: March 12, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jeffrey Randall NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY RANDALL (NPI 1053782656) is an individual clinical provider in Portland, Oregon, licensed in Oregon (L7994) and active in the NPI registry since October 2015. He has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1053782656
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJEFFREY RANDALL
Location Address3500 NE MLK BLVD STE 200Portland, OR 97212-2093
Mailing AddressPo Box 82819Portland, OR 97282-0819
Phone(503) 327-8205
Sole ProprietorYes
Enumeration DateOctober 8, 2015
Last NPPES UpdateMarch 12, 2019
✔ NPI 1053782656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OR · L7994
Definition
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3500 NE MLK BLVD STE 200, Portland, OR 97212
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jeffrey Randall has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2024 through April 1, 2028.

Opt-Out Effective DateApril 1, 2024
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER COOPER LPC, CADCII
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 237-8205
RILEY ELIZABETH SHAFFER LCSW
Social Worker (Clinical)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 327-8205
KRISTEN MICHELLE HELMS PMHNP-BC
Psychiatry & Neurology (Psychiatry)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 327-8205
IONELA CIMPAN
Student in an Organized Health Care Education/Training Program
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 233-5405
MARTHA B DIAZ LPC
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 253-4600
MRS. LAUREN J LA RIVA LPC
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 327-8205
MARIA DE LOS ANGELES ZACARIAS PAZ
Social Worker
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 233-5405
ADAM KIM MS/EDS, LPC, NCC
Counselor (Professional)
3500 NE MLK BLVD STE 200
PORTLAND, OR 97212
Multnomah County (503) 327-8205

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Randall's NPI number?

The NPI number for Jeffrey Randall is 1053782656. It was assigned to this individual provider in the NPPES registry on October 8, 2015.

Where is Jeffrey Randall located?

Jeffrey Randall practices at 3500 NE Mlk Blvd Ste 200, Portland, OR 97212. The listed phone number is (503) 327-8205.

What is Jeffrey Randall's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jeffrey Randall enrolled in Medicare?

No. Jeffrey Randall has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Jeffrey Randall accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan list Jeffrey Randall as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeffrey Randall was last updated on March 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.