Provider Demographics
NPI:1073628525
Name:ROGERS, SCOTT G (LMLP, LCP)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:G
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMLP, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-1407
Mailing Address - Country:US
Mailing Address - Phone:620-285-7256
Mailing Address - Fax:
Practice Address - Street 1:610 E GRANT AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KS
Practice Address - Zip Code:67054-2708
Practice Address - Country:US
Practice Address - Phone:620-723-2272
Practice Address - Fax:620-723-3450
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMLP 0120103T00000X
KSLCP 062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist