Corinne Ann Rogers, PSYD.,LP
Individual provider Active NPI Psychologist · Pleasant Ridge, MI
NPI 1467495275 · NPPES record last updated Oct 15, 2019
Key facts
- NPI
- 1467495275
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 6301012708 (MI)
- Practice address
- 23650 Woodward Ave Ste 109
Pleasant Ridge, MI 48069-1141 - Phone
- (248) 219-6627
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
23650 Woodward Ave
Suite 109
Pleasant Ridge, MI 48069-1141
Phone (248) 219-6627
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071126000117 | MI | Practitioner - Clinical Psychologist | 8527156702 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301012708 | MI | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301012708 | MI | Yes |
Addresses
Primary practice location
23650 Woodward Ave Ste 109
Pleasant Ridge, MI 48069-1141
Mailing address
1017 Cadieux Rd
Grosse Pointe Park, MI 48230-1511
Phone (248) 219-6627
Other practice location 1
28511 Orchard Lake Rd
Suite A
Farmington Hills, MI 48334-2933
Phone (248) 489-1550
Other practice location 2
221 S Main St
Royal Oak, MI 48067-2653
Phone (248) 398-6459
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- Kelly Nack
- Tom Obertynski
- Valerie Kay Overholt
- Royal Oak Family Dentistry
- Dale C Scarlett
- SFT Enterprises Inc
- Susan Andrea Tacke
- Jessica Terhorst
All providers in Pleasant Ridge, MI · Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.