Individual provider Active NPI

Venita Catrice Randall, MA, LPC, LPCS, LAC

  • Counselor
  • Little River, SC
National Provider Identifier
1972784916
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
657 Twinflower St
Little River, SC 29566-7444
Phone
(704) 561-1913
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counselor 101Y00000X Primary

Addresses

Primary practice location

657 Twinflower St
Little River, SC 29566-7444

Mailing address

PO Box 924
North Myrtle Beach, SC 29597-0924
Phone (843) 945-0658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20241126002978 SC Practitioner - Mental Health Counselor 8325573405 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 28, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Oct 28, 2024 Accepting new patients
Randall Counseling and Therapy Services, LLC PastSince Nov 3, 2024 Accepting new patients

Locations

164 Waccamaw Medical Park Dr
Conway, SC 29526
Phone (843) 347-4888

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1972784916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 924",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295970924",
            "telephone_number": "843-945-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 TWINFLOWER ST",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667444",
            "telephone_number": "704-561-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "VENITA",
        "middle_name": "CATRICE",
        "credential": "MA, LPC, LPCS, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

Verify at the official NPI Registry.