Natalie Randolph, DBH, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-18386 Issued in AZ

Practice address

2700 S Woodlands Village Blvd Ste 300
Flagstaff, AZ 86001-7127

Phone

(928) 600-6737

NPI assigned

Feb 24, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1730835182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 N ERIN WAY",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011085",
            "telephone_number": "928-600-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S WOODLANDS VILLAGE BLVD STE 300",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017127",
            "telephone_number": "928-600-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "NATALIE",
        "name_prefix": "Dr.",
        "credential": "DBH, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-18386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Louise Randall, M.D.
• Bryce Aldworth Randall, CRNA
• Stephen Randazzo, NP
• Curtis Glen Randolph, LPC
• Matthew Randolph, DO
• Raquel Mickelson LPC LLC
• Aaron Alan Rasband, LPC
• Theresa Yvonne Gray Rashdan, MSN, CPNP-PC/AC, FNP
• Erin Rasmussen, ACNPC-AG
• Joe Rauschenbach

• Clinical Social Worker in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.