Provider Demographics
NPI:1003236662
Name:ROGERS, RUQAIYAH SHARIAH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:RUQAIYAH
Middle Name:SHARIAH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6026 KALAMAZOO AVE SE STE 139
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-7018
Mailing Address - Country:US
Mailing Address - Phone:616-536-1520
Mailing Address - Fax:
Practice Address - Street 1:6026 KALAMAZOO AVE SE STE 139
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-7018
Practice Address - Country:US
Practice Address - Phone:616-537-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010909321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical