DR. ALICE H RANDOLPH (EDD MSCP) – Clinical Psychologist, NPI 1497865885
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,139 CLINICAL PSYCHOLOGIST in OH
Provider Addresses for DR. ALICE H RANDOLPH (EDD MSCP)
Goodwill, 205, Southeast Catawba Road, Port Clinton, Portage Township, Ottawa County, Ohio, 43452, United States
SUITE A
PORT CLINTON, OH 434522666
Phone: (216) 215-8000
Fax: (877) 734-2032
Type: Mailing
3872 E HARBOR LIGHT LANDING DR
PORT CLINTON, OH 434523877
Phone: (216) 215-8000
Fax: (877) 734-2032
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-02-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120210000485 | I | Clinical Psychologist | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 46 | 17 | $0 |
| 90834 | Psychotherapy, 45 minutes | 31 | 21 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 30 | 30 | $0 |
Insurance plans in this area (ZIP 43452)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| Clinical Psychologist | OH | |
| - | OH | |
| Clinical Psychologist | OH | |
| Clinical Psychologist | OH | |
| - | OH |
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