RANDOLPH SCOTT HOLLINGSWORTH, LPC/:ISAC — NPI 1285871855 (Licensed & Credentialed Counselor in HOLBROOK, AZ)

CMS-1500 Box 24J / 33a • NPI

1285871855

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

101Y00000X

Licensed & Credentialed Counselor

Box 32 Service Location & ZIP+4

1305 SPURLOCK AVE, HOLBROOK, AZ, 86025-1960

✓ 9-Digit EDI 837 ZIP+4 (86025-1960)

Practice Phone & Referral Fax

(520) 249-8428

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1285871855 (RANDOLPH SCOTT HOLLINGSWORTH, LPC/:ISAC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1285871855` (NPI-1 Individual Practitioner)
Provider / Legal Name	RANDOLPH SCOTT HOLLINGSWORTH, LPC/:ISAC
Plain-English Specialty	Licensed & Credentialed Counselor NUCC Code: `101Y00000X` (Counselor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1305 SPURLOCK AVE, HOLBROOK, AZ, 86025-1960
Practice Telephone / Fax	Tel: (520) 249-8428
Administrative Mailing Address	1305 SPURLOCK AVE, HOLBROOK, AZ, 86025-1960
Enumeration & Last Sync	Enumerated: 2009-01-19 \| CMS Record Updated: 2026-05-27

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1305 SPURLOCK AVE, HOLBROOK, AZ, 86025-1960

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Plain-English Taxonomy & CMS Crosswalk (101Y00000X)

What Does Taxonomy Code 101Y00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101Y00000X translates to:
"Licensed & Credentialed Counselor"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (RANDOLPH SCOTT HOLLINGSWORTH, LPC/:ISAC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YA0400X` — Counselor, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)	State: AZ \| License: `LISAC-10504` \| Primary: Secondary
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: AZ \| License: `LPC -12687` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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RANDOLPH SCOTT HOLLINGSWORTH, LPC/:ISAC (NPI #1285871855)