Individual provider Active NPI

Tiffany Nicole Randazza, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Hickory, NC
National Provider Identifier
1487004545
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
22810 Issued in NC
Practice address
327 1St Ave NW
Hickory, NC 28601-6122
Phone
(828) 695-5900
Fax
(828) 695-4256
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 22810 NC Primary

Addresses

Primary practice location

327 1St Ave NW
Hickory, NC 28601-6122

Mailing address

327 1St Ave NW
Hickory, NC 28601-6122
Phone (828) 695-5900

Other practice location 1

1170A Fairgrove Church Rd
Hickory, NC 28602-9695
Phone (828) 464-1172 ext. 2630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22810NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1487004545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 1ST AVE NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286016122",
            "telephone_number": "828-695-5900",
            "fax_number": "828-695-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 1ST AVE NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286016122",
            "telephone_number": "828-695-5900",
            "fax_number": "828-695-4256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170A Fairgrove Church Rd",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286029695",
            "country_code": "US",
            "telephone_number": "828-464-1172 x2630",
            "fax_number": "828-464-1175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDAZZA",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "22810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.