Roger Dean Allen, PHD
Individual provider Active NPI Clinical Psychologist · Elizabeth City, NC
NPI 1972594869 · NPPES record last updated Oct 26, 2011
Key facts
- NPI
- 1972594869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- HSPP0954 (NC)
- Practice address
- 301 E Church St
Elizabeth City, NC 27909-4805 - Phone
- (252) 338-8821
- Fax
- (252) 338-8821
- NPI assigned
- Oct 31, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Albemarle Psychological Services
Practice addresses (Care Compare)
301 E Church St
Elizabeth City, NC 27909-4805
Phone (252) 338-8821
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 |
|---|---|---|---|---|
| I20120224000761 | NC | Practitioner - Clinical Psychologist | 5799753364 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HSPP0954 | NC | MD | Clinical Psychologist |
| 0954 | NC | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albemarle Psychological Services | Current |
Accepting new patients |
Locations
301 E Church St
Elizabeth Cty, NC 27909
Phone (252) 338-8821
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | HSPP0954 | NC | Yes |
Addresses
Primary practice location
301 E Church St
Elizabeth City, NC 27909-4805
Mailing address
PO Box 303
Elizabeth City, NC 27907-0303
Phone (252) 338-8821
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94483 | Other | NC | MEDCOST |
| 03119 | Other | NC | BLUE CROSS BLUE SHIELD |
| 6000148 | Medicaid | NC |
Other providers in Elizabeth City, NC
- Alison L. Boone, DDS
- All the Small Things Inc
- Melissa Allard
- Allen Eye Associates Inc
- Alethea Miller Allen
- Saree Allen
- Alternative Health Solutions PC
- Joseph Michael Alvarez
- America Health and Human Services
- American Health & Human Services
All providers in Elizabeth City, NC · Clinical Psychologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2011. 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.