Provider Demographics
NPI:1336328905
Name:ROGERS, MELANIA DELCARMEN (MSW, AAC)
Entity Type:Individual
Prefix:
First Name:MELANIA
Middle Name:DELCARMEN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MSW, AAC
Other - Prefix:
Other - First Name:MELANIA
Other - Middle Name:
Other - Last Name:PINOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N HOWARD ST STE W
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0508
Mailing Address - Country:US
Mailing Address - Phone:818-371-7262
Mailing Address - Fax:
Practice Address - Street 1:2366 COTTONWOOD CREEK RD
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-9532
Practice Address - Country:US
Practice Address - Phone:818-371-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW609139321041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker