Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaeghan W Randolph

Individual provider Counselor · NPI 1447745120

Kaeghan W Randolph is a Mental Health Counselor in Canton, Ohio. Qualified in 2018, 8 years ago. Practices with Phoenix Rising Behavioral Healthcare and Recovery, Inc, a 30-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
8
Licensed in
OH
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

624 Market Ave N
Canton, OH 44702-1017
Phone: (330) 493-4553
Fax: (330) 493-3761
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence E2202756 (OH)
Counselor Taxonomy 101Y00000X

Record details

NPI number1447745120
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 26, 2018
Last updated in NPPESMay 28, 2024
Certification dateMay 28, 2024
Mailing address624 Market Ave N, Canton, OH 44702-1017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Phoenix Rising Behavioral Healthcare And Recovery, Inc. — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Canton