Individual provider Active NPI

Razhedatequila Eunicetage Sanford, LCSW LCAS CSI

  • Community/Behavioral Health Agency
  • Gastonia, NC
National Provider Identifier
1306374160
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
C015805 Issued in NC
Practice address
3481 Bear Den Dr
Gastonia, NC 28052-0009
Phone
(704) 689-1577
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X C015805 NC
Clinical Social Worker 1041C0700X C015805 NC
Community/Behavioral Health Agency 251S00000X C015805 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 25881 NC

Addresses

Primary practice location

3481 Bear Den Dr
Gastonia, NC 28052-0009

Mailing address

3481 Bear Den Dr
Gastonia, NC 28052-0009
Phone (704) 689-1577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240530000384 NC Practitioner - Clinical Social Worker 2264874775 Reassigns benefits to 1 organization
I20241113001021 SC Practitioner - Clinical Social Worker 2264874775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3481 Bear Den Dr
Gastonia, NC 28052-0009
Phone (704) 689-1577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25881NCMDAddiction (Substance Use Disorder) Counselor
C015805NCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Recovery Center, LLC Community/Behavioral Health Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1306374160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3481 BEAR DEN DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280520009",
            "telephone_number": "704-689-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3481 BEAR DEN DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280520009",
            "telephone_number": "704-689-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "RAZHEDATEQUILA",
        "middle_name": "EUNICETAGE",
        "name_prefix": "Ms.",
        "credential": "LCSW LCAS CSI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C015805",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015805",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C015805",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "25881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.