Provider Demographics
NPI:1285839563
Name:ROGERS, LOU WINGO (LPC)
Entity Type:Individual
Prefix:
First Name:LOU
Middle Name:WINGO
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 FLINTLOCK CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-7406
Mailing Address - Country:US
Mailing Address - Phone:864-269-0181
Mailing Address - Fax:
Practice Address - Street 1:900 GREENVILLE DRIVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:SC
Practice Address - Zip Code:29697
Practice Address - Country:US
Practice Address - Phone:864-847-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional