DR. ROGER LYNN ERICKSON PH.D. NPI 1669829230

NPI Information

  • NPI: 1669829230
  • Provider Name: DR. ROGER LYNN ERICKSON, PH.D.
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3230 BROADMOOR AVE SE STE D
    KENTWOOD, MI
    ZIP 49512
  • Phone: (616) 228-1914

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NPI Details

DR. Roger Lynn Erickson, PH.D. is a clinical psychologist in Kentwood, MI. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Roger Lynn Erickson, PH.D. NPI is 1669829230. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3230 BROADMOOR AVE SE STE D
KENTWOOD, MI
ZIP 49512-180
Phone: (616) 228-1914
Fax: (616) 333-4927

The NPI 1669829230 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 5/24/2016 and was last updated on 3/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TR0400XPsychologistRehabilitation6301016004MICHIGANNo
2103TC0700XPsychologistClinical6301016004MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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