PHYLLIS RANDLE (NPI# 1376736124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376736124 |
| Entity Type | Individual |
| Full Name | PHYLLIS RANDLE |
| Credential | LCSW-C |
| Practice Address |
1400 Mercantile Ln 232 Largo MD 20774-5341 |
| Practice Telephone | 3015830001 |
| Practice Fax Number | 3015833403 |
| Mailing Telephone | 3015830001 |
| Mailing Fax Number | 3015833403 |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2007-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
09062 | MD | Behavioral Health & Social Service Providers |
| Street Address |
1400 MERCANTILE LN 232 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-5341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972596690 | Barbara Christine Williamson | Dermatology | 1400 Mercantile Ln, Ste#110, Largo, MD 20774-5341 | 2005-08-28 |
| 1699229021 | Growth Connections LLC | Social Worker | 1400 Mercantile Ln, Suite 260, Largo, MD 20774-5341 | 2016-08-15 |
| 1164884151 | Shirelle Wright | Social Worker | 1400 Mercantile Ln, Suite 260, Largo, MD 20774-5341 | 2016-03-28 |
| 1003214891 | Livin' The Light, LLC | Case Manager/Care Coordinator | 1400 Mercantile Ln, Suite 208, Largo, MD 20774-5341 | 2014-12-11 |
| 1669716395 | Visage Dermatology and Aesthetic Center, LLC | Dermatology | 1400 Mercantile Ln, Suite 110, Largo, MD 20774-5341 | 2012-11-19 |
| 1265709364 | Emery Jefferies | Counselor | 1400 Mercantile Ln, #232, Largo, MD 20774-5341 | 2011-11-17 |
| 1831485911 | Timothy Pass | Clinic/Center | 1400 Mercantile Ln, 232, Largo, MD 20774-5341 | 2011-06-27 |
| 1972897767 | Linda Uwanaka Ebonine | Physician Assistant | 1400 Mercantile Ln, Suite 200, Largo, MD 20774-5341 | 2011-06-08 |
| 1184916975 | Patrice Amos Brown | Occupational Therapist | 1400 Mercantile Ln, 240, Largo, MD 20774-5341 | 2011-05-11 |
| 1467751289 | Yvonne D Loftin-woodard | Social Worker | 1400 Mercantile Ln, 232, Largo, MD 20774-5341 | 2011-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071304 | Penny Lane Howland | Social Worker | 11310 112th Ct, Largo, FL 33778-3110 | 2020-10-23 |
| 1689296535 | Thomas Patitucci | Social Worker | 12025 68th Way, Largo, FL 33773-3332 | 2020-05-14 |
| 1295381457 | Patricia Marin | Social Worker | 7850 Ulmerton Rd Ste 2a, Largo, FL 33771-4015 | 2019-08-14 |
| 1730672676 | Linnea Camar Leverson | Social Worker | 10251 Prince Pl Apt 106, Largo, MD 20774-1118 | 2018-06-13 |
| 1437670072 | Marja Lindsey Reed | Social Worker | 1300 Mercantile Ln Ste 100n, Largo, MD 20774-5390 | 2017-07-05 |
| 1619418225 | Britani Lalone | Social Worker | 801 W Bay Dr Ste 334, Largo, FL 33770-3227 | 2017-03-15 |
| 1760928949 | Next Place Therapy Services | Social Worker | 1300 Mercantile Ln Ste 100g2, Largo, MD 20774-5383 | 2017-01-12 |
| 1639628605 | New Directions Therapeutic Services LLC | Social Worker | 9701 Apollo Dr # 100, Largo, MD 20774-9998 | 2016-09-30 |
| 1962889659 | Francesca M Anthony | Social Worker | 11419 93rd St, Largo, FL 33773-4616 | 2015-05-01 |
| 1639591548 | Lisa Gordon | Social Worker | 9500 Arena Dr Ste 460c, Largo, MD 20774-3755 | 2014-01-11 |
| Find all providers in LARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.