Roger R. Harrison, PHD
Individual provider Active NPI Clinical Psychologist · Wilmington, DE
NPI 1356523716 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1356523716
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PS020166 (PA)
- Practice address
- A.I. Dupont Hospital for Children
1600 Rockland Road
Wilmington, DE 19803-3607 - Phone
- (302) 651-4000
- Fax
- (302) 651-4945
- NPI assigned
- Nov 28, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS020166 | PA | MD | Clinical Psychologist |
| B10000777 | DE | MD | Group Psychotherapy Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | B10000777 | DE | |
| Group Psychotherapy Psychologist | 103TP2701X | B10000777 | DE | |
| Clinical Psychologist | 103TC0700X | PS020166 | PA | Yes |
Addresses
Primary practice location
A.I. Dupont Hospital for Children
1600 Rockland Road
Wilmington, DE 19803-3607
Mailing address
Nemours Childrens Clinic
P.O. Box 404112
Atlanta, GA 30384-0001
Phone (904) 390-3610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102087416 | Medicaid | PA | |
| 4138473 | Medicaid | MD | |
| 147192 | Medicaid | NJ |
Other providers in Wilmington, DE
- Barbara E Harrison
- Beth Harrison
- Britani Rachelle Harrison
- Caitlin Harrison
- Lexus Janae Harrison
- Scott Harrison
- Shamar Dieudonne Harrison
- William J Harrison III
- Charity Rena Hart
- Krystal Hart
All providers in Wilmington, DE · Clinical Psychologist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.