Peninsula Consulting Services, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13117 Issued in MD

Legal business name

PENINSULA CONSULTING SERVICES, INC.

Practice address

104 Williamsport Cir
Suite C
Salisbury, MD 21804-6400

Phone

(443) 859-8699

Fax

(443) 859-8747

NPI assigned

Feb 6, 2012

Last updated

Feb 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyantha G Randall, LCSW-CNPI 1407052400

Title

Owner

Phone

(443) 859-8699

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyantha G. Randall, LCSW-C

  • Clinical Social Worker
  • Salisbury, MD
  • NPI 1407052400
  Authorized official Same address or phone

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1356613491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WILLIAMSPORT CIR",
            "address_2": "SUITE C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046400",
            "telephone_number": "443-859-8699",
            "fax_number": "443-859-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WILLIAMSPORT CIR",
            "address_2": "SUITE C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046400",
            "telephone_number": "443-859-8699",
            "fax_number": "443-859-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA CONSULTING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "TYANTHA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-859-8699",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Pellegrino, M.D.
• Pemberton Apothecary, LLC (Pemberton Apothecary)
• Peninsula Addiction Services
• Peninsula Allergy & Asthma Associates P a
• Peninsula Cardiology Associates, P.a.
• Peninsula Dental Care LLC
• Peninsula Dental Center PC
• Peninsula Dermatology Associates,P.a.
• Peninsula Eye Center PA
• Peninsula Eye Center, P.a (Peninsula Cataract & Laser Center)

• Clinical Social Worker in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.