Individual provider Active NPI

Roger E. Lauer, PH.D.

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1639393614
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007927 Issued in MI
Practice address
5864 Interface Dr Ste D
Ann Arbor, MI 48103-9514
Phone
(734) 994-9466
Fax
(734) 994-9465
NPI assigned
Apr 12, 2007
Last updated
Oct 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301007927 MI
Group Psychotherapy Psychologist 103TP2701X 6301007927 MI
Clinical Psychologist 103TC0700X 6301007927 MI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 6301007927 MI
Family Psychologist 103TF0000X 6301007927 MI
Forensic Psychologist 103TF0200X 6301007927 MI
Clinical Neuropsychologist 103G00000X 6301007927 MI
Psychologist 103T00000X 6301007927 MI
Adult Development & Aging Psychologist 103TA0700X 6301007927 MI

Addresses

Primary practice location

5864 Interface Dr Ste D
Ann Arbor, MI 48103-9514

Mailing address

5864 Interface Dr Ste D
Ann Arbor, MI 48103-9514
Phone (734) 994-9466

Other identifiers 1

IdentifierTypeStateIssuer
680H112930OtherMIBLUE CROSS BLUE SHIELD

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
6301007927MIMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CNLD Neuropsychology PC Clinical CurrentSince Jan 1, 2023 Accepting new patients
Center for Neuropsychology & Learning Clinical Neuropsychologist Past Accepting new patients

Locations

5864 Interface Dr
Ste D
Ann Arbor, MI 48103
Phone (734) 535-7446

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1639393614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 INTERFACE DR STE D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039514",
            "telephone_number": "734-994-9466",
            "fax_number": "734-994-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5864 INTERFACE DR STE D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039514",
            "telephone_number": "734-994-9466",
            "fax_number": "734-994-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUER",
        "first_name": "ROGER",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007927",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MI",
            "license": "6301007927",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680H112930",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.