Healthcare Provider Details

I. General information

NPI: 1659558500
Provider Name (Legal Business Name): JULIANNE BETH RANDALL-MESSENGER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIANNE BETH RANDALL LMSW

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 STONEY VIEW DR STE 200
SHELBY TOWNSHIP MI
48316-4970
US

IV. Provider business mailing address

6060 STONEY VIEW DR STE 200
SHELBY TOWNSHIP MI
48316-4970
US

V. Phone/Fax

Practice location:
  • Phone: 517-282-5427
  • Fax:
Mailing address:
  • Phone: 517-282-5427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121696
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851114822
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: