Individual provider Active NPI

Randall Gary Garland Jr., LCSW

  • Clinical Social Worker
  • Titusville, FL
National Provider Identifier
1710614318
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW20281 Issued in FL
Practice address
2355 Truman Scarborough Way
Titusville, FL 32796-1310
Phone
(321) 210-2813
NPI assigned
Aug 3, 2022
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW20281 FL Primary

Addresses

Primary practice location

2355 Truman Scarborough Way
Titusville, FL 32796-1310

Mailing address

4905 Brookhaven St
Cocoa, FL 32927-8381
Phone (321) 210-2813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240607000016 FL Practitioner - Clinical Social Worker 3274971791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clear As a Bell Psychiatric Providers, IncGroup PAC ID 8729436464, 4 clinicians

Practice addresses (Care Compare)

1007 Pathfinder Way
Suite 120
Rockledge, FL 32955-3243
Phone (321) 507-4033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW20281FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clear As a Bell Psychiatric Providers, Inc Clinical CurrentSince Apr 30, 2024 Accepting new patients

Locations

1007 Pathfinder Way
Ste 120
Rockledge, FL 32955
Phone (321) 507-4033

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.

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1710614318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 BROOKHAVEN ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329278381",
            "telephone_number": "321-210-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 TRUMAN SCARBOROUGH WAY",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327961310",
            "telephone_number": "321-210-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARLAND",
        "first_name": "RANDALL",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.