Provider Demographics
NPI:1912512831
Name:JOSHUA ROOKS, PHD, LLC
Entity Type:Organization
Organization Name:JOSHUA ROOKS, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-403-5958
Mailing Address - Street 1:7328 JACARANDA LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2670
Mailing Address - Country:US
Mailing Address - Phone:616-403-5958
Mailing Address - Fax:
Practice Address - Street 1:7328 JACARANDA LN
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2670
Practice Address - Country:US
Practice Address - Phone:616-403-5958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty