Provider Demographics
NPI:1437233756
Name:ROGERS, CHRISTINA (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:CROTTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 KINNEY AVE APT 34
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2162
Mailing Address - Country:US
Mailing Address - Phone:512-707-2782
Mailing Address - Fax:512-707-2783
Practice Address - Street 1:2403 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7534
Practice Address - Country:US
Practice Address - Phone:512-707-2782
Practice Address - Fax:512-707-2783
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX345991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical