Theodora Lugene Randolph

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CI5305 Issued in NV

Practice address

3514 E Tropicana Ave Ste 2C
Las Vegas, NV 89121-7351

Phone

(029) 923-2897

NPI assigned

Feb 15, 2013

Last updated

Oct 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Theodora Lugene Randolph Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1245570027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W WARM SPRINGS RD APT 3916",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890145520",
            "telephone_number": "702-544-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 E TROPICANA AVE STE 2C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891217351",
            "telephone_number": "029-923-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "THEODORA",
        "middle_name": "LUGENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI5305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THEODORA",
            "last_name": "RANDOLPH",
            "middle_name": "LUGENE",
            "credential": "MS, LCPC INTERN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lavontae Larod Randolph
• Lobridget Randolph
• Monica Aileen Randolph
• Retha M Randolph
• Roddrecka Rae'Onna Randolph
• Alexandra Rands
• Patrick Rane Jr.
• Santosh Gopal Rane, M.D.
• Andrea Raney
• Vishweshwar Ranga, M.D.

• Professional Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.