Provider Demographics
NPI:1376276535
Name:ROGERS, JAMES JR (LLPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ROGERS
Suffix:JR
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16250 NORTHLAND DR STE 204
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5226
Mailing Address - Country:US
Mailing Address - Phone:248-599-7522
Mailing Address - Fax:
Practice Address - Street 1:16250 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5205
Practice Address - Country:US
Practice Address - Phone:248-599-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022233101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health