Active NPI
Susan Randolph, M.S.
- Mental Health Counselor
- Charlottesville, VA
National Provider Identifier
1083022347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701003379
- Practice address
- 233 Hydraulic Ridge Rd
205
Charlottesville, VA 22901-8129 - Phone
- (434) 409-9367
- NPI assigned
- Jul 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701003379 | VA | Primary |
Addresses
Primary practice location
233 Hydraulic Ridge Rd
205
Charlottesville, VA 22901-8129
Mailing address
233 Hydraulic Ridge Rd
205
Charlottesville, VA 22901-8129
Phone (434) 409-9367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701003379 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1083022347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 HYDRAULIC RIDGE RD",
"address_2": "205",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229018129",
"telephone_number": "434-409-9367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 HYDRAULIC RIDGE RD",
"address_2": "205",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229018129",
"telephone_number": "434-409-9367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "SUSAN",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-30",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701003379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.