Provider Demographics
NPI:1417938861
Name:HOCK, ROBERT A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:HOCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 STRAIGHT ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1060
Mailing Address - Country:US
Mailing Address - Phone:513-721-0990
Mailing Address - Fax:513-721-5313
Practice Address - Street 1:415 STRAIGHT ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1060
Practice Address - Country:US
Practice Address - Phone:513-721-0990
Practice Address - Fax:513-721-5313
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3161103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0525220Medicaid
OH0525220Medicaid