Active NPI
Pamela Joyce Randolph, PHD MSPH LCDC
- Addiction (Substance Use Disorder) Counselor
- Arlington, TX
National Provider Identifier
1639772833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15495
- Practice address
- 1627 Saddle Creek Cir Apt 1537
Arlington, TX 76015-3978 - Phone
- (214) 414-7601
- NPI assigned
- Nov 19, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15495 | TX | Primary |
Addresses
Primary practice location
1627 Saddle Creek Cir Apt 1537
Arlington, TX 76015-3978
Mailing address
1627 Saddle Creek Cir Apt 1537
Arlington, TX 76015-3978
Phone (214) 414-7601
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | integralhealthwealth@gmail.com | Direct |
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
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Jiji's Integral Health Center Inc | Current | Accepting new patients |
Locations
600 W Park Row Dr
Ste A
Arlington, TX 76010
Phone (214) 642-2769
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Arlington, TX
- NPI 1154067759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1639772833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 SADDLE CREEK CIR APT 1537",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760153978",
"telephone_number": "214-414-7601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 SADDLE CREEK CIR APT 1537",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760153978",
"telephone_number": "214-414-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "PAMELA",
"middle_name": "JOYCE",
"name_prefix": "Dr.",
"credential": "PHD MSPH LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2020-12-14",
"certification_date": "2020-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "15495",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "integralhealthwealth@gmail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1627 Saddle Creek Cir Apt 1537",
"city": "Arlington",
"state": "TX",
"country_code": "US",
"postal_code": "760153978",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.