Active NPI
Shanice Monique Randall, LMSW
- Social Worker
- Upper Marlboro, MD
National Provider Identifier
1851998694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 23077
- Practice address
- 14202 Water Fowl Way
Upper Marlboro, MD 20774-4002 - Phone
- (301) 257-6282
- NPI assigned
- Oct 5, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 23077 | MD | Primary |
Addresses
Primary practice location
14202 Water Fowl Way
Upper Marlboro, MD 20774-4002
Mailing address
14202 Water Fowl Way
Upper Marlboro, MD 20774-4002
Phone (301) 257-6282
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23077 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1851998694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14202 WATER FOWL WAY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207744002",
"telephone_number": "301-257-6282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14202 WATER FOWL WAY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207744002",
"telephone_number": "301-257-6282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "SHANICE",
"middle_name": "MONIQUE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-05",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "23077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upper Marlboro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.