Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JEREMY B ROARK, PH.D.

Active Sole Proprietor

DR. JEREMY B ROARK, PH.D. is a Psychologist healthcare provider located in ADA, Michigan. NPI 1578860193 is currently active in the NPPES registry. Verify at CMS.

Psychologist · ADA, MI

Registration Details

NPI Number: 1578860193
Provider Type: Individual
Gender: Male
NPI Issued: Feb 16, 2011 (15.479534009292 yrs)
Last Updated: Feb 1, 2024
License: PSY 24012 (CA)
Sole Proprietor: Yes

Practice Information

Address: 2650 SHUMAC LN SE

ADA, MI, 493019355
Browse MI providers · Browse ZIP 49301
Phone: 8055707688
Primary Specialty: Psychologist
103T00000X

Other Psychologist Providers in ADA, MI

Name	Credential	NPI
SEAN MICHAEL DOUGHERTY	MA LLP	1902841968
DR. DANIEL ROSEN	ED.D, ABPP	1083719090
DR. DANE VERMERRIS	ED.D.	1639235989
DR. DANIEL KEITH EHNIS	EDD	1679602361
DR. JULIA A MOHR	PSY.D.	1548393283
DR. RICHARD RALEIGH RAUBOLT	PH.D.	1568608230

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.