Individual provider Active NPI

Kristine B Rand, LCSW

  • Clinical Social Worker
  • Norfolk, VA
National Provider Identifier
1497029011
Registry record updated Oct 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007871 Issued in VA
Practice address
208 E Plume St # 327B
Norfolk, VA 23510-1757
Phone
(757) 637-0840
NPI assigned
Feb 29, 2012
Last updated
Oct 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00664356 VA
Clinical Social Worker 1041C0700X 0904007871 VA Primary

Addresses

Primary practice location

208 E Plume St # 327B
Norfolk, VA 23510-1757

Mailing address

208 E Plume St # 327B
Norfolk, VA 23510-1757
Phone (757) 637-0840

Other identifiers 1

IdentifierTypeStateIssuer
1497029011MedicaidVA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130807000630 VA Practitioner - Clinical Social Worker 9931341757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidal Counseling, PLCGroup PAC ID 7012392053, 2 clinicians

Practice addresses (Care Compare)

208 E Plume St
Suite 327B
Norfolk, VA 23510-1757
Phone (757) 637-0840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007871VAMDClinical Social Worker
00664356VAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Tidal Counseling, PLC Mental Health CurrentSince May 11, 2022 Accepting new patients
Ruetzel Gynecology & Obstetrics PastSince Dec 22, 2015 Accepting new patients
Unvaled Psychological PLLC PastSince Apr 1, 2021 Accepting new patients
William K Rand, III, Gynecology PLLC Past Accepting new patients

Locations

208 E Plume St
#327B
Norfolk, VA 23510
Phone (757) 637-0840

208 E Plume St
Ste 327B
Norfolk, VA 23510
Phone (757) 472-8530

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12771/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666396800000",
    "number": "1497029011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E PLUME ST # 327B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101757",
            "telephone_number": "757-637-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E PLUME ST # 327B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101757",
            "telephone_number": "757-637-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAND",
        "first_name": "KRISTINE",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2022-10-22",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "00664356",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497029011",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.