Individual provider · Type 1 NPI
Lori Randolph, LCSW, PEL, CYT 200
Clinical Social Worker · Jonesboro, IL
Practice location
2805 State Route 127 S
Jonesboro, IL 62952-1326
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 149.030335 (IL) |
| School Social Worker | 1041S0200X | 2546182 (IL) |
Clinical Social Worker: 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 interpers…
Another provider at this address
About NPI 1154290757
Lori Randolph, LCSW, PEL, CYT 200's National Provider Identifier is 1154290757, issued on Nov 3, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Jonesboro, IL. The record was last updated on Nov 3, 2025.