Roger D Colonna, PSYCHOLOGIST ED D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1656 Issued in NJ

Practice address

115 US Highway 46 BLDG F
Mountain Lakes, NJ 07046-1668

Phone

(973) 239-4141

NPI assigned

Aug 16, 2006

Last updated

Mar 8, 2026By the provider in NPPES

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 names 1

• Dr. Roger D Colonna Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 7, 2026 through Apr 7, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772928000000",
    "number": "1346353109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 US HIGHWAY 46 BLDG F",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461668",
            "telephone_number": "973-239-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 US HIGHWAY 46 BLDG F",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461668",
            "telephone_number": "973-239-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLONNA",
        "first_name": "ROGER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST ED D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2026-03-08",
        "certification_date": "2026-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "1656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROGER",
            "last_name": "COLONNA",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "EDD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Psychologist in Mountain Lakes, NJ
• Providers in Mountain Lakes, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.