Provider Demographics
NPI:1982624656
Name:CAWLEY, ROGER C (PHD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:C
Last Name:CAWLEY
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 1:458 OLD STREET RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1216
Mailing Address - Country:US
Mailing Address - Phone:603-924-4690
Mailing Address - Fax:603-924-3183
Practice Address - Street 1:458 OLD STREET RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1201
Practice Address - Country:US
Practice Address - Phone:603-924-4690
Practice Address - Fax:603-924-3183
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH197103T00000X
MA2213103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist