Provider Demographics
NPI:1841389657
Name:ROGERS, VINCENT CHARLES (MSW;LCSW;SAP)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:CHARLES
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MSW;LCSW;SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1820
Mailing Address - Country:US
Mailing Address - Phone:717-645-5233
Mailing Address - Fax:717-234-3205
Practice Address - Street 1:160 S PROGRESS AVE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4636
Practice Address - Country:US
Practice Address - Phone:717-645-5233
Practice Address - Fax:717-657-3073
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW010672L1041C0700X
PACW0194141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA743100708OtherVAUE OPTIONS