Provider Demographics
NPI:1568682433
Name:ROGERS, JENNIFER MICHELE (BA, CSAC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:BA, CSAC
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Other - Credentials:
Mailing Address - Street 1:37 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-6326
Mailing Address - Country:US
Mailing Address - Phone:304-542-5558
Mailing Address - Fax:
Practice Address - Street 1:4851 HWY 421 S.
Practice Address - Street 2:
Practice Address - City:BUIES CREEK
Practice Address - State:NC
Practice Address - Zip Code:27506
Practice Address - Country:US
Practice Address - Phone:910-893-5727
Practice Address - Fax:910-893-6404
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)