Provider Demographics
NPI:1346920261
Name:ROGERS, BRIANA (LPCA)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 EMERALD LN
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3315
Mailing Address - Country:US
Mailing Address - Phone:607-222-7021
Mailing Address - Fax:
Practice Address - Street 1:22 EMERALD LN
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:CT
Practice Address - Zip Code:06524-3315
Practice Address - Country:US
Practice Address - Phone:607-222-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6394101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional