Provider Demographics
NPI:1932394582
Name:ROGAT, THOMAS MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:ROGAT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 GREEN RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5725
Mailing Address - Country:US
Mailing Address - Phone:510-915-3252
Mailing Address - Fax:216-223-6423
Practice Address - Street 1:3601 GREEN RD
Practice Address - Street 2:SUITE 314
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5725
Practice Address - Country:US
Practice Address - Phone:510-915-3252
Practice Address - Fax:216-223-6423
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23025103TC0700X
OH6865103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164396Medicaid