Mark Manfred Roland, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1872 Issued in GA

Practice address

21 Trammel St. SW
Psychological Consultants of Marietta PC
Marietta, GA 30064-3249

Phone

(770) 420-9448

Fax

(770) 420-9441

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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 Consultants of Marietta, PC

  • Marriage & Family Therapist
  • Marietta, GA
  • NPI 1093802233

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1104960715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "address_2": "PSYCHOLOGICAL CONSULTANTS OF MARIETTA PC",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300610515",
            "telephone_number": "770-420-9448",
            "fax_number": "770-420-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TRAMMEL ST. SW",
            "address_2": "PSYCHOLOGICAL CONSULTANTS OF MARIETTA PC",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643249",
            "telephone_number": "770-420-9448",
            "fax_number": "770-420-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "MARK",
        "middle_name": "MANFRED",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00661691A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brad L Rohr, MD
• Siripong Rojanasthien, M.D.
• Joana Lizbeth Rojas
• Reketa Rojas, LPC
• Ann Davis Roland, LMFT
• Dorothy Michaela Rollins, ATC
• Lacohlia Jade Rollins, BS, RBT
• Roseann C Rollins, D.C.
• Nikolas Joseph Romage, DC
• Ronald E. Durie, Jr., LLC

• Clinical Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.