Tarah Randazzo, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2600 N Mayfair Rd
Suite 650
Milwaukee, WI 53226-1309

Phone

(414) 771-9304

Fax

(414) 771-9543

NPI assigned

Mar 7, 2017

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Previously, effective Aug 29, 2024 through Aug 29, 2026

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Shore Counseling and Consulting Clinic, S.C.

  • Group Psychotherapy Psychologist
  • Milwaukee, WI
  • NPI 1588710073
  NPD (past)

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1770023970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE 650",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-771-9304",
            "fax_number": "414-771-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE 650",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-771-9304",
            "fax_number": "414-771-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDAZZO",
        "first_name": "TARAH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Litisha Marie Ramus, FNP
• Beverly Jean Rand, RN
• Letitia Rand, SACIT
• Scott D Rand, MD
• Melinda M Randa, LCSW
• Edward L Randerson, M.D.
• Amber M Randle, RDH
• Terrisha Lee Randle, LPN
• Robert Randolph
• Randy R Ciepluch (Family Dental Center)

• Professional Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.