Provider Demographics
NPI:1821179805
Name:ROZEL, KENT EMERY (PHD)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:EMERY
Last Name:ROZEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:KENT
Other - Middle Name:E
Other - Last Name:ROZEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:8340 KINSMAN RD
Mailing Address - Street 2:
Mailing Address - City:NOVELTY
Mailing Address - State:OH
Mailing Address - Zip Code:44072-9577
Mailing Address - Country:US
Mailing Address - Phone:216-291-1845
Mailing Address - Fax:440-510-5151
Practice Address - Street 1:2000 AUBURN DR STE 200
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4328
Practice Address - Country:US
Practice Address - Phone:216-291-1845
Practice Address - Fax:440-510-5151
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000295650OtherANTHEM
OH680014706OtherRAILROAD MEDICARE
OH71209OtherQUALCHOICE
OH080210000OtherMAGELLAN
OH0966674Medicaid
OH680014706OtherRAILROAD MEDICARE
OH000000295650OtherANTHEM