Phyllis Randle, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09062 Issued in MD

Practice address

1400 Mercantile LN
232
Largo, MD 20774-5341

Phone

(301) 583-0001

Fax

(301) 583-3403

NPI assigned

Aug 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Better Morning

  • Community/Behavioral Health Agency
  • Riverdale, MD
  • NPI 1497122535

  DC

  Medicare reassignment
• Community Counseling & Mentoring Services, Inc

  • Clinic/Center
  • Largo, MD
  • NPI 1306881057
  NPD (past)
• Community Counseling & Mentoring Services,Inc

  • Clinic/Center
  • Largo, MD
  • NPI 1942462049
  NPD (past)
• Jyoti Behl Mdpa

  • Mental Health Counselor
  • Greenbelt, MD
  • NPI 1447566054
  NPD (past)

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1376736124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN",
            "address_2": "232",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745341",
            "telephone_number": "301-583-0001",
            "fax_number": "301-583-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN",
            "address_2": "232",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745341",
            "telephone_number": "301-583-0001",
            "fax_number": "301-583-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "PHYLLIS",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qci Behavioral Health Consulting Group, LLC
• Qci Behavioral Health Consulting Group, LLC
• R I C Health Services LLC
• Saraswathy Ramachandran, MD
• Adrienne D. Randall, PT
• Shashi H Ranganath, MD
• Ramya Sree Ravolkol
• Sasha Ray, MD
• Keisha L Redd, PHARM.D.
• Redeemed Innocence LLC

• Clinical Social Worker in Largo, MD
• Providers in Largo, 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 Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.