Heather Fitz-Randolph, RIC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

0704013225 Issued in VA

Practice address

306 Garrisonville Rd Ste 201
Stafford, VA 22554-1575

Phone

(540) 602-7615

NPI assigned

Jun 30, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Bridge to Wellness Centers, LLC

  • Professional Counselor
  • Vienna, VA
  • NPI 1427608124
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1467022483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 MOHEGAN DR APT 102",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220432534",
            "telephone_number": "703-201-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 GARRISONVILLE RD STE 201",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541575",
            "telephone_number": "540-602-7615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1934 Old Gallows Rd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221824040",
            "country_code": "US",
            "telephone_number": "703-752-6181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZ-RANDOLPH",
        "first_name": "HEATHER",
        "credential": "RIC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0704013225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Stafford, VA
• Providers in Stafford, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.