Corey Roos, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

003934 Issued in CT

Practice address

25 Lewis St Ste 202
Greenwich, CT 06830-5537

Phone

(203) 623-5882

NPI assigned

Mar 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1699216242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NICOLL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112624",
            "telephone_number": "203-623-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LEWIS ST STE 202",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068305537",
            "telephone_number": "203-623-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Roche, LCSW
• Peter Brook Rockholz, LCSW, M.S.S.W.
• Norma Roelke, CSW
• Michele Rohr, M.D.
• Samantha Nicole Roller, MSW
• Linda Ann Rosemann, MS, CCC-SLP
• Rosemary Ryan, D.D.S., L.L.C.
• Danya J Rosen, M.D.
• Leigh D. Rosen, MD
• Jared Wayne Rosenberg, M.D.

• Clinical Psychologist in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.