Provider Demographics
NPI:1174828933
Name:ROGERS, ERIN BOSWELL (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:BOSWELL
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 LORELL TER
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4115
Mailing Address - Country:US
Mailing Address - Phone:901-826-1560
Mailing Address - Fax:
Practice Address - Street 1:1775 MEMPHIS ST
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-1703
Practice Address - Country:US
Practice Address - Phone:901-826-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1309101YP2500X
GA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional