Provider Demographics
NPI:1407617384
Name:ROGERS, VERONICA (LMHC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 NORTH AVE UNIT 5-1AA
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1647
Mailing Address - Country:US
Mailing Address - Phone:781-208-0780
Mailing Address - Fax:
Practice Address - Street 1:591 NORTH AVE UNIT 5-1AA
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1647
Practice Address - Country:US
Practice Address - Phone:781-208-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health