Carla Randolph, LCSW, CSAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904009394 Issued in VA

Practice address

806 N 30TH St
Richmond, VA 23223-6641

Phone

(804) 241-2324

NPI assigned

Aug 29, 2016

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

• Carla Randolph Professional name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New Life, LLC

  • Community/Behavioral Health Agency
  • Newport News, VA
  • NPI 1710234240
  Medicare reassignment NPD
• The Wellness Institute, LLC

  • Community/Behavioral Health Agency
  • Richmond, VA
  • NPI 1235753476
  NPD (past) Authorized official
• New Life, LLC

  • Community/Behavioral Health Agency
  • Newport News, VA
  • NPI 1174913099
  NPD

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1407302573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 N 30TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236641",
            "telephone_number": "804-241-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 N 30TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236641",
            "telephone_number": "804-241-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "CARLA",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "RANDOLPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ronald Mark Ramus, MD
• Armstrong Andrew Ran, PA-C
• Noor Rana, MD
• Christian Ross Randazzo, MD
• Abigail Randolph
• David M Randolph II, MD
• Holly Randolph, OTD
• Jessica Dionne Randolph, MD
• Krystal L. Randolph, M.S., ATC, VATL
• Sherwood Alfonso Randolph Jr., LCSW

• Clinical Social Worker in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.