Provider Demographics
NPI:1700227642
Name:ROGERS HUG, HEIDI NORINE (CADC I)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:NORINE
Last Name:ROGERS HUG
Suffix:
Gender:F
Credentials:CADC I
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:NORINE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3425 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1340
Mailing Address - Country:US
Mailing Address - Phone:541-523-7400
Mailing Address - Fax:541-523-4927
Practice Address - Street 1:3700 MIDWAY
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-1466
Practice Address - Country:US
Practice Address - Phone:541-523-8320
Practice Address - Fax:541-523-8325
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR010737101YA0400X
OR19-QMHA-I002532101YM0800X
OR17-CRM-193175T00000X
OR12-06-84101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist