Provider Demographics
NPI:1265420566
Name:HESS, ROGER N (PHD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:N
Last Name:HESS
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 1:24100 CHAGRIN BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5545
Mailing Address - Country:US
Mailing Address - Phone:216-321-3025
Mailing Address - Fax:216-831-1269
Practice Address - Street 1:24100 CHAGRIN BLVD
Practice Address - Street 2:STE 140
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5545
Practice Address - Country:US
Practice Address - Phone:216-321-3025
Practice Address - Fax:216-831-1269
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH558103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP02091Medicare ID - Type Unspecified