Provider Demographics
NPI:1518391655
Name:ROGERS, BRENDA L (LMFT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 S 332ND PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98001-5154
Mailing Address - Country:US
Mailing Address - Phone:206-472-1850
Mailing Address - Fax:
Practice Address - Street 1:33507 9TH AVE S
Practice Address - Street 2:SUITE C-3
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6397
Practice Address - Country:US
Practice Address - Phone:206-472-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor