Provider Demographics
NPI:1295891612
Name:PAROLINI, ROGER J (PHD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:J
Last Name:PAROLINI
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 1:9239 W CENTER RD
Mailing Address - Street 2:STE 227
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1900
Mailing Address - Country:US
Mailing Address - Phone:402-393-2893
Mailing Address - Fax:402-393-1279
Practice Address - Street 1:9239 W CENTER RD
Practice Address - Street 2:STE 227
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1900
Practice Address - Country:US
Practice Address - Phone:402-393-2893
Practice Address - Fax:402-393-1279
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE182103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE106207000OtherMIS
NE8437OtherBLUE CROSS BLUE SHIELD
NE8437OtherBLUE CROSS BLUE SHIELD