Individual provider Active NPI

Natasha Lynn Randall, LCSW

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1295233161
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011216 Issued in VA
Practice address
600 Jackson St
Fredericksburg, VA 22401-5719
Phone
(540) 373-3223
Fax
(540) 371-3753
NPI assigned
Jan 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904011216 VA Primary

Addresses

Primary practice location

600 Jackson St
Fredericksburg, VA 22401-5719

Mailing address

1033 Bakersfield LN
Fredericksburg, VA 22401-2783
Phone (202) 327-3613

Other names 1

  • Natasha Lynn Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190926001799 VA Practitioner - Clinical Social Worker 3072843507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rappahannock Area Community Services BoardGroup PAC ID 8123016318, 39 clinicians

Practice addresses (Care Compare)

600 Jackson St
Fredericksburg, VA 22401-5719
Phone (540) 373-3223

Hospital & facility affiliations

  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904011216VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rappahannock Area Community Services Board Multi-Specialty CurrentSince Aug 14, 2019 Accepting new patients
New Vision Counseling and Consulting, LLC Clinical Current Accepting new patients

Locations

600 Jackson St
Fredericksburg, VA 22401
Phone (540) 373-3223

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1295233161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 BAKERSFIELD LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224012783",
            "telephone_number": "202-327-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JACKSON ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224015719",
            "telephone_number": "540-373-3223",
            "fax_number": "540-371-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "NATASHA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "JOHNSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.