RANDA SOUBRA LICSW
NPI 1083247910
Social Worker - Clinical in Rochester, MN

Q: What is Randa Soubra's NPI number?

The NPI number for Randa Soubra is 1083247910. It was assigned to this individual provider in the NPPES registry on February 19, 2020.

Q: What is Randa Soubra's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Randa Soubra was last updated on August 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since February 19, 2020PECOS EnrolledAccepts Medicare Assignment

200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: August 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 27, 2020, Mar 2, 2020, Feb 19, 2020 (3 updates tracked since 2020).

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About Randa Soubra Licsw NPPES

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

RANDA SOUBRA LICSW (NPI 1083247910) is an individual clinical provider in Rochester, Minnesota, licensed in Minnesota (24457) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1083247910

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameRANDA SOUBRACredential: LICSW

Location Address200 1ST ST SWRochester, MN 55905-0001

Mailing Address200 1st St SwRochester, MN 55905-0001 · (507) 284-2511

Phone(507) 284-2511

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateFebruary 19, 2020

Last NPPES UpdateAugust 27, 20203 updates tracked since enumeration

NPPES CertifiedAugust 27, 2020

✔ NPI 1083247910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MN · 24457

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.

200 1ST ST SW, Rochester, MN 55905

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Randa Soubra Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305274630

PECOS Enrollment IDI20200319000727

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

EMILY LEASURE MD

Internal Medicine