Provider Demographics
NPI:1285643395
Name:VOLK, ROGER MALCOLM (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:MALCOLM
Last Name:VOLK
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 80 BOX 11541
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96367-0018
Mailing Address - Country:US
Mailing Address - Phone:0116145-711-9580
Mailing Address - Fax:
Practice Address - Street 1:18TH MEDICAL GROUP, KADENA AB,
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5142
Practice Address - Country:US
Practice Address - Phone:0116145-711-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040007971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical