Provider Demographics
NPI:1629546783
Name:ROGERS, SHERRITA Y (EDD)
Entity Type:Individual
Prefix:DR
First Name:SHERRITA
Middle Name:Y
Last Name:ROGERS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:MS
Other - First Name:SHERRITA
Other - Middle Name:
Other - Last Name:PENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:PO BOX 3952
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27836-1952
Mailing Address - Country:US
Mailing Address - Phone:252-228-1500
Mailing Address - Fax:
Practice Address - Street 1:601 COUNTRY CLUB DR STE F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6124
Practice Address - Country:US
Practice Address - Phone:252-228-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103T00000XBehavioral Health & Social Service ProvidersPsychologist