Provider Demographics
NPI:1518366301
Name:ROGERS, EMMA (LGSW-C)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LGSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 COOVER RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6921
Mailing Address - Country:US
Mailing Address - Phone:443-906-3506
Mailing Address - Fax:
Practice Address - Street 1:79 WEST ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2426
Practice Address - Country:US
Practice Address - Phone:443-906-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical