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JACQUELINE RANDOLPH
NPI 1578970059
Counselor - Mental Health in St. Louis, MO

Active since July 17, 2014
4218 NORTH GRAND BLVD, ST. LOUIS, MO 63107(314) 534-6624(314) 535-4394 Get Directions Write a Review

NPPES record last updated: July 17, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jacqueline Randolph NPPES

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

JACQUELINE RANDOLPH (NPI 1578970059) is an individual mental health provider in St. Louis, Missouri and active in the NPI registry since July 2014.

NPPES Registry Identity

NPI1578970059
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE RANDOLPH
Location Address4218 NORTH GRAND BLVDSt. Louis, MO 63107
Mailing Address4218 North Grand BlvdSt. Louis, MO 63107 · (314) 534-6624 · Fax (314) 535-4394
Phone(314) 534-6624
Fax(314) 535-4394
Sole ProprietorNo
Enumeration DateJuly 17, 2014
✔ NPI 1578970059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
4218 NORTH GRAND BLVD, St. Louis, MO 63107
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Other Providers at the Same Location NPPES 4

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

MR. CHRIS S BRIGGS
Counselor (Mental Health)
4218 NORTH GRAND BLVD
ST. LOUIS, MO 63107
St. Louis City (314) 534-6624
MISS ANNETTE MICHELLE COOK CNA LEVEL 1 MED AIDE
Counselor (Mental Health)
4218 NORTH GRAND BLVD
ST. LOUIS, MO 63107
St. Louis City (314) 534-6624
JOSEPH B CLARK
Counselor (Mental Health)
4218 NORTH GRAND BLVD
ST. LOUIS, MO 63107
St. Louis City (314) 534-6624
MRS. MARSHA J IVESTER
Counselor (Addiction (Substance Use Disorder))
4218 NORTH GRAND BLVD
ST. LOUIS, MO 63107
St. Louis City (314) 534-6624

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 Jacqueline Randolph's NPI number?

The NPI number for Jacqueline Randolph is 1578970059. It was assigned to this individual provider in the NPPES registry on July 17, 2014.

Where is Jacqueline Randolph located?

Jacqueline Randolph practices at 4218 North Grand Blvd, St. Louis, MO 63107. The listed phone number is (314) 534-6624.

What is Jacqueline Randolph's specialty?

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

When was this NPI record last updated?

The NPPES record for Jacqueline Randolph was last updated on July 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.