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MARINA LYNN RANDLES LCMHCA
NPI 1407481435
Counselor - Mental Health in Davidson, NC

Active since March 10, 2020Opted out of Medicare · through Apr 12, 2028
452 S MAIN ST STE H, DAVIDSON, NC 28036(704) 651-9851 Get Directions Write a Review

NPPES record last updated: March 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Marina Lynn Randles Lcmhca NPPES

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

MARINA LYNN RANDLES LCMHCA (NPI 1407481435) is an individual mental health provider in Davidson, North Carolina, licensed in North Carolina (A14662) and active in the NPI registry since March 2020. She has opted out of Medicare through April 12, 2028.

NPPES Registry Identity

NPI1407481435
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARINA LYNN RANDLESCredential: LCMHCA
Location Address452 S MAIN ST STE HDavidson, NC 28036-7058
Mailing Address291 Bridges Farm RdMooresville, NC 28115-8757 · (704) 651-9851
Phone(704) 651-9851
Sole ProprietorNo
Enumeration DateMarch 10, 2020
Last NPPES UpdateMarch 13, 2020
NPPES CertifiedMarch 13, 2020
✔ NPI 1407481435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · A14662
452 S MAIN ST STE H, Davidson, NC 28036
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Marina Lynn Randles Lcmhca 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 12, 2024 through April 12, 2028.

Opt-Out Effective DateApril 12, 2024
Opt-Out In Effect ThroughApril 12, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Marina Randles's NPI number?

The NPI number for Marina Randles is 1407481435. It was assigned to this individual provider in the NPPES registry on March 10, 2020.

Where is Marina Randles located?

Marina Randles practices at 452 S Main St Ste H, Davidson, NC 28036. The listed phone number is (704) 651-9851.

What is Marina Randles's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Marina Randles enrolled in Medicare?

No. Marina Randles has opted out of Medicare through April 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Marina Randles was last updated on March 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.