Individual provider Active NPI

Rolake O Tomori, PSY.D.

  • Clinical Psychologist
  • Marietta, GA
National Provider Identifier
1063555266
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003452 Issued in GA
Practice address
800 Kennesaw Ave NW Ste 150
Marietta, GA 30060-7941
Phone
(470) 328-9806
NPI assigned
Feb 15, 2007
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY003452 GA Primary

Addresses

Primary practice location

800 Kennesaw Ave NW Ste 150
Marietta, GA 30060-7941

Mailing address

PO Box 6181
Marietta, GA 30065-0181
Phone (916) 912-8906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20240125002302 GA Practitioner - Clinical Psychologist 3476710617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY003452GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Psychotherapy, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1063555266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6181",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300650181",
            "telephone_number": "916-912-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENNESAW AVE NW STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607941",
            "telephone_number": "470-328-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMORI",
        "first_name": "ROLAKE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.