Brooke Randolph, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

007746 Issued in GA

Practice address

301 Heritage Walk Ste 101
Woodstock, GA 30188-6450

Phone

(770) 591-5852

Fax

(770) 591-5957

NPI assigned

Mar 27, 2012

Last updated

Mar 27, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1437425295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HERITAGE WALK STE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886450",
            "telephone_number": "770-591-5852",
            "fax_number": "770-591-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HERITAGE WALK STE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886450",
            "telephone_number": "770-591-5852",
            "fax_number": "770-591-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "BROOKE",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "007746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Radin
• Catherine Wilson Rahaim, LCSW
• Naveen T Raj, D.O
• Julie Taylor Rambo, MS, RD, LD
• Emily J Ramirez, MSW
• Donna W. Ratliff, EDS.,LPC,NCC
• Alvin Jerome Rattle Jr., DDS
• Jonathan Heath Raughton, LCSW
• Rausch Family Practice
• Judith T Rausch, M.D.

• Speech-Language Pathologist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.