Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jason Randall, PSYD

Individual provider Clinical Psychologist · NPI 1679885602

Jason Randall, PSYD is a Clinical Psychologist in Portage, Michigan. Graduated from Loma Linda University School of Medicine in 2004, 22 years ago. Practices with Grace Health Inc, a 28-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
22
Trained at
Loma Linda University School of Medicine
Licensed in
MI
In the registry since
2010
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

3770 Glenkerry Ct
Portage, MI 49024-0700
Phone: (269) 329-2887
Fax: (269) 329-2805
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6301014496 (MI)

Record details

NPI number1679885602
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedJuly 7, 2010
Last updated in NPPESJuly 7, 2010
Mailing address61 Commerce Ave Sw, Grand Rapids, MI 49503-4124

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Grace Health Inc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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