Alice H Randolph, EDD MSCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2974 Issued in OH

Practice address

3872 E Harbor Light Landing Dr
Port Clinton, OH 43452-3877

Phone

(216) 215-8000

Fax

(877) 734-2032

NPI assigned

Aug 30, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Transitions, IncGroup PAC ID 6305748187, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Psychological Transitions, Inc

  • Clinical Psychologist
  • Port Clinton, OH
  • NPI 1902914278
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497865885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SE CATAWBA RD",
            "address_2": "SUITE A",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522666",
            "telephone_number": "216-215-8000",
            "fax_number": "877-734-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3872 E HARBOR LIGHT LANDING DR",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434523877",
            "telephone_number": "216-215-8000",
            "fax_number": "877-734-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "ALICE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "EDD MSCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "2974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000137850",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473590",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "294762000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00127008",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonardo T Que, M.D.
• Virgie U Que, M.D.
• Kristen Marie Quisno-Witt, CCC-SLP
• Radiology Services of Ohio, Inc.
• Kevindeep Raju, PHARMD
• Michelle A Rathfelder, LSW
• Madeline Marie Recker, PHARMD
• Angela Reineck, R.N.
• Patrick Anthony Reineck, D.D.S.
• Jade Marie Reynolds

• Clinical Psychologist in Port Clinton, OH
• Providers in Port Clinton, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.