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LORI RANDOLPH LCSW, PEL, CYT 200
NPI 1154290757
Social Worker - Clinical in Jonesboro, IL

Active since November 03, 2025PECOS Enrolled
2805 STATE ROUTE 127 S, JONESBORO, IL 62952(618) 685-0580 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lori Randolph Lcsw, Pel, Cyt 200 NPPES

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

LORI RANDOLPH LCSW, PEL, CYT 200 (NPI 1154290757) is an individual clinical provider in Jonesboro, Illinois, licensed in Illinois (149.030335) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1154290757
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameLORI RANDOLPHCredential: LCSW, PEL, CYT 200
Location Address2805 STATE ROUTE 127 SJonesboro, IL 62952-1326
Mailing Address2805 State Route 127 SJonesboro, IL 62952-1326 · (618) 685-0580
Phone(618) 685-0580
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateNovember 3, 2025
NPPES CertifiedNovember 2, 2025
✔ NPI 1154290757 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 IL · 149.030335
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 ListedSocial Worker · SchoolTaxonomy 1041S0200X · License 2546182 (IL)
2805 STATE ROUTE 127 S, Jonesboro, IL 62952
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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 (PECOS)

Lori Randolph Lcsw, Pel, Cyt 200 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002398633
PECOS Enrollment IDI20260304000081
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62952 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 $54.80 – $168.44
Typical copayment $0.00 (range $13.70 – $42.11)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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

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

MINDFUL PATHWAYS FAMILY COUNSELING CENTER, PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
2805 STATE ROUTE 127 S
JONESBORO, IL 62952
Union County (618) 685-0580

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 Lori Randolph's NPI number?

The NPI number for Lori Randolph is 1154290757. It was assigned to this individual provider in the NPPES registry on November 3, 2025.

Where is Lori Randolph located?

Lori Randolph practices at 2805 State Route 127 S, Jonesboro, IL 62952. The listed phone number is (618) 685-0580.

What is Lori Randolph's specialty?

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

Is Lori Randolph enrolled in Medicare?

Yes. Lori Randolph is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lori Randolph was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.