Provider Demographics
NPI:1154085058
Name:ROGERS, SUNNAYE (LMSW)
Entity Type:Individual
Prefix:
First Name:SUNNAYE
Middle Name:
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 1:2104 PINEY BRANCH CIR APT 313
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1835
Mailing Address - Country:US
Mailing Address - Phone:667-232-0866
Mailing Address - Fax:
Practice Address - Street 1:2104 PINEY BRANCH CIR APT 313
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1835
Practice Address - Country:US
Practice Address - Phone:667-232-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker