Provider Demographics
NPI:1003355660
Name:ROGAK, HANNAH (LMFT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:ROGAK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 11TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2954
Mailing Address - Country:US
Mailing Address - Phone:612-760-3558
Mailing Address - Fax:
Practice Address - Street 1:720 8TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-3420
Practice Address - Country:US
Practice Address - Phone:320-333-9228
Practice Address - Fax:320-251-0217
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist