Provider Demographics
NPI:1164928925
Name:ROGERS, SARAH M (LCP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N BROADWAY AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2301
Mailing Address - Country:US
Mailing Address - Phone:316-425-7774
Mailing Address - Fax:316-425-7779
Practice Address - Street 1:200 N BROADWAY AVE FL 5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2301
Practice Address - Country:US
Practice Address - Phone:316-425-7774
Practice Address - Fax:316-425-7779
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2367103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling