PATRICK D RANDOLPH PHD INC (NPI# 1740267285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740267285 |
| Entity Type | Organization |
| Organization Name | PATRICK D RANDOLPH PHD INC |
| Other Organization Name | LIGHTHOUSE BEHAVIORAL HEALTH |
| Practice Address |
4630 50th St Suite 509 Lubbock TX 79414 |
| Mailing Address |
6502 Slide Rd Suite 207 Lubbock TX 79424-1329 |
| Practice Telephone | 8067718808 |
| Practice Fax Number | 8067718809 |
| Mailing Telephone | 8067718808 |
| Mailing Fax Number | 8067718809 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2010-07-23 |
| Authorized Official Name | DR. PATRICK D RANDOLPH (OWNER) |
| Authorized Official Telephone | 8067718808 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 24796 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 0095MQ | 01 |
| Other Name | Type Code |
|---|---|
| Lighthouse Behavioral Health | Doing Business As Name - Organization |
| Street Address |
4630 50TH ST SUITE 509 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720473218 | Cecily Gibson | Marriage & Family Therapist | 4630 50th St, Lubbock, TX 79414-3521 | 2015-04-01 |
| 1346526381 | Yan Yan Cheng, Md, Pa | Psychiatry & Neurology | 4630 50th St, Suite 506-a, Lubbock, TX 79414-3521 | 2011-10-21 |
| 1386973758 | George E Comiskey | Counselor | 4630 50th St, Suite 509, Lubbock, TX 79414-3521 | 2009-12-15 |
| 1952634974 | Christy Kay Oden | Counselor | 4630 50th St, Lubbock, TX 79414-3521 | 2009-09-09 |
| 1205062296 | Stephen Joseph Breaud | Dentist | 4630 50th St, Ste 505, Lubbock, TX 79414-3521 | 2009-06-03 |
| 1669592275 | Edward Madoc Thomas | Marriage & Family Therapist | 4630 50th St, Suite 412, Lubbock, TX 79414-3521 | 2007-03-29 |
| 1164542783 | Shiloh Counseling Services | Marriage & Family Therapist | 4630 50th St, Suite 412, Lubbock, TX 79414-3521 | 2007-03-29 |
| 1083768998 | Walter Pitts Davis | Marriage & Family Therapist | 4630 50th St, Suite 507, Lubbock, TX 79414-3521 | 2007-01-22 |
| 1144390410 | Denise Frazier Bartley | Psychologist | 4630 50th St, Suite 509, Lubbock, TX 79414-3521 | 2006-11-08 |
| 1760491914 | Kevin W. Pope | Dentist | 4630 50th St, #508, Lubbock, TX 79414-3521 | 2006-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275182032 | Ensight Vision LLC | Optometrist | 6002 Slide Road, Lubbock, TX 79414 | 2019-09-05 |
| 1932697604 | Lone Star Mobile Med | Family Medicine | 5504 Wayne Ave Ste 105, Lubbock, TX 79414 | 2018-04-27 |
| 1679986806 | Nicole Evans-taylor | Pharmacist | 4847 Slide Road, Lubbock, TX 79414 | 2014-06-05 |
| 1679911697 | Jamel Deshane Vaughn | Optometrist | 6002 Slide Rd Ste P-8, Lubbock, TX 79414 | 2013-06-12 |
| 1659663284 | Vision One Associates | Optometrist | 6221 Slide Road, Lubbock, TX 79414 | 2011-05-16 |
| 1154445963 | C M Davis Od Pllc | Optometrist | 6002 Slide Road Suite P-8, Lubbock, TX 79414 | 2007-03-19 |
| 1922154632 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 5602 Slide Road, Lubbock, TX 79414 | 2007-01-26 |
| 1043393846 | Emily Rose Bohn | Physical Therapist | 3501 S. Loop 289, Lubbock, TX 79414 | 2006-10-23 |
| 1720176928 | Vann Alexander Home Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 5313 50th Street, Suite D-5, Lubbock, TX 79414 | 2006-10-11 |
| 1952499279 | Bradley Derl Brooks | Dentist | 5301 50th Street #200, Lubbock, TX 79414 | 2006-10-11 |
| Find all providers in zip 79414 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336786870 | Bailey P Tackett | Psychologist | 2024 82nd St Unit 103, Lubbock, TX 79423-4343 | 2019-12-03 |
| 1992215503 | Sharla Boyd, Ph.d., Pllc | Psychologist | 6824 Wayne Ave Ste 1, Lubbock, TX 79424-1649 | 2017-10-10 |
| 1760917371 | Discovery Medical Network Telehealth, LLC | Psychologist | 2950 50th St, Lubbock, TX 79413-4326 | 2017-04-21 |
| 1558806729 | Elizabeth Eliot Dennard | Psychologist | 5502 58th St Ste 600, Lubbock, TX 79414-2087 | 2016-12-27 |
| 1942679535 | Shena Smith | Psychologist | 2034 82nd St Unit 103, Lubbock, TX 79423 | 2015-09-24 |
| 1316121320 | Michael Daniel Gomez | Psychologist | 6610 Quaker Ave, Lubbock, TX 79413 | 2007-12-27 |
| 1205044740 | Texas Tech University Psychology Clinic | Psychologist | 18th Street and Boston Avenue, Lubbock, TX 79409 | 2007-05-18 |
| 1699983098 | Richard Scotten Wampler | Psychologist | Marriage and Family Therapy, Aps, Box 41162, Texas Tech University, Lubbock, TX 79409-1162 | 2007-05-18 |
| 1154465409 | George Gary Walker | Psychologist | 5120 29th Dr Ste C, Lubbock, TX 79407-2612 | 2007-02-19 |
| 1013060946 | Patrick David Randolph | Psychologist | 5147 69th St Ste D, Lubbock, TX 79424-1646 | 2007-01-22 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.