Active NPI
Anthony Darryl Randolph Jr.
- Clinical Social Worker
- Virginia Beach, VA
National Provider Identifier
1487524138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW04361
- Practice address
- 3708 Joppa LN
Virginia Beach, VA 23456-5709 - Phone
- (757) 580-0902
- NPI assigned
- Nov 7, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW04361 | RI | Primary |
Addresses
Primary practice location
3708 Joppa LN
Virginia Beach, VA 23456-5709
Mailing address
3708 Joppa LN
Virginia Beach, VA 23456-5709
Phone (757) 580-0902
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW04361 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762473600000",
"number": "1487524138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3708 JOPPA LN",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234565709",
"telephone_number": "757-580-0902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3708 JOPPA LN",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234565709",
"telephone_number": "757-580-0902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "ANTHONY",
"middle_name": "DARRYL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-11-07",
"last_updated": "2025-11-07",
"certification_date": "2025-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "CSW04361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.