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NPI Code Detail

MEDICARE: DR. ROGER HOWARD RISS PSY.D.

MEDICARE: DR. ROGER HOWARD RISS PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist193NE
2103T00000XPsychologist193NE

General Provider Information

NPI Number : 1275624066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER HOWARD RISS PSY.D.
Provider Business Mailing Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-483-9597
Fax Number : 402-486-8177
Provider Business Practice Location Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-483-9597
Fax Number : 402-486-8177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 09/11/2025

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