Provider Demographics
NPI:1346529344
Name:ROGART, STEPHANIE BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:BETH
Last Name:ROGART
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4383 TRIAS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1157
Mailing Address - Country:US
Mailing Address - Phone:619-261-3266
Mailing Address - Fax:
Practice Address - Street 1:4383 TRIAS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1157
Practice Address - Country:US
Practice Address - Phone:619-261-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical