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RANDALL KENNETH SHIVELY PH.D, LICDC
NPI 1235608084
Psychologist - Intellectual and Developmental Disabilities in Columbus, OH

Active since November 21, 2018
2100 STELLA CT, COLUMBUS, OH 43215(614) 252-8402(614) 252-5326 Get Directions Write a Review

NPPES record last updated: April 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Randall Kenneth Shively Ph.d, Licdc NPPES

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

RANDALL KENNETH SHIVELY PH.D, LICDC (NPI 1235608084) is an individual intellectual and developmental disabilities provider in Columbus, Ohio, licensed in Ohio (4374) and active in the NPI registry since November 2018.

NPPES Registry Identity

NPI1235608084
Entity TypeIndividualMale
Primary Taxonomy103TM1800X
Provider Legal NameRANDALL KENNETH SHIVELYCredential: PH.D, LICDC
Location Address2100 STELLA CTColumbus, OH 43215-1011
Mailing Address2100 Stella CtColumbus, OH 43215-1011 · (614) 252-8402 · Fax (614) 252-5326
Phone(614) 252-8402
Fax(614) 252-5326
Sole ProprietorYes
Enumeration DateNovember 21, 2018
Last NPPES UpdateApril 25, 2023
NPPES CertifiedApril 25, 2023
✔ NPI 1235608084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Intellectual and Developmental DisabilitiesBehavioral Health & Social Service Providers
Taxonomy Code103TM1800X
License✔ Licensed in OH · 4374
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 975850 (OH)
2100 STELLA CT, Columbus, OH 43215
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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.

DEBORAH FINNEGAN
Counselor
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402
TINA HOWARD
Community Health Worker
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402
OSSIE MAE DORNOO CNP
Nurse Practitioner (Psychiatric/Mental Health)
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402
NELLIE M REMSON
Counselor (Addiction (Substance Use Disorder))
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (515) 867-4177
SHELLY L THIGPEN QMHSIII
Counselor
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402
SAMANTHA JO BRAY CDCA
Counselor (Addiction (Substance Use Disorder))
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402
RACHEL MULLENS PARAPROFESSIONAL
Behavior Technician
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402
MISTI SELLERS PSYD
Student in an Organized Health Care Education/Training Program
2100 STELLA CT
COLUMBUS, OH 43215
Franklin County (614) 252-8402

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 Randall Shively's NPI number?

The NPI number for Randall Shively is 1235608084. It was assigned to this individual provider in the NPPES registry on November 21, 2018.

Where is Randall Shively located?

Randall Shively practices at 2100 Stella Ct, Columbus, OH 43215. The listed phone number is (614) 252-8402.

What is Randall Shively's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Intellectual and Developmental Disabilities, with taxonomy code 103TM1800X.

When was this NPI record last updated?

The NPPES record for Randall Shively was last updated on April 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.