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

Lori Randolph, LCSW, PEL, CYT200

Individual provider Clinical Social Worker · NPI 1154290757

Lori Randolph, LCSW, PEL, CYT200 is a Clinical Social Worker in Jonesboro, Illinois. Qualified in 2021, 5 years ago. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2025
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

2805 State Route 127 S
Jonesboro, IL 62952-1326
Phone: (618) 685-0580
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149.030335 (IL)
School Social Worker Taxonomy 1041S0200X · Licence 2546182 (IL)

Record details

NPI number1154290757
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , PEL , CYT200
Sole proprietorNo
NPI enumeratedNovember 3, 2025
Last updated in NPPESNovember 3, 2025
Certification dateNovember 2, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated