Provider Demographics
NPI:1407915192
Name:ROGERS, KARA ELIZABETH (LICENSED COUNSELOR)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:ELIZABETH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LICENSED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BEVERLY CIR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-3014
Mailing Address - Country:US
Mailing Address - Phone:770-707-1391
Mailing Address - Fax:770-707-1391
Practice Address - Street 1:10 WILSON RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-4433
Practice Address - Country:US
Practice Address - Phone:770-506-9575
Practice Address - Fax:770-506-9369
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional