NPIMap

Individual provider Active NPI

Carolyn Pender Roche, PH.D., NCSP

  • Clinical Child & Adolescent Psychologist
  • Durham, NC
National Provider Identifier
1306176490
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
3845
Practice address
5318 Highgate Dr
Suite 132
Durham, NC 27713-6630
Phone
(919) 228-8845
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3845 NC
Cognitive & Behavioral Psychologist 103TB0200X 3845
Clinical Psychologist 103TC0700X 3845 NC
Clinical Child & Adolescent Psychologist 103TC2200X 3845 Primary
Family Psychologist 103TF0000X 3845 NC
School Psychologist 103TS0200X 3845 NC

Addresses

Primary practice location

5318 Highgate Dr
Suite 132
Durham, NC 27713-6630

Mailing address

5318 Highgate Dr
Suite 132
Durham, NC 27713-6630
Phone (919) 228-8845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3845NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Next Step Psychology PLLC Clinical Neuropsychologist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1306176490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 HIGHGATE DR",
            "address_2": "SUITE 132",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136630",
            "telephone_number": "919-228-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5318 HIGHGATE DR",
            "address_2": "SUITE 132",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136630",
            "telephone_number": "919-228-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "CAROLYN",
        "middle_name": "PENDER",
        "name_prefix": "Dr.",
        "credential": "PH.D., NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "3845",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": "3845",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3845",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": "3845",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NC",
            "license": "3845",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NC",
            "license": "3845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.