Provider Demographics
NPI:1841595378
Name:ROGERS, ELIZABETH MACY (LPC, NCC, DCC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MACY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC, NCC, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3937
Mailing Address - Country:US
Mailing Address - Phone:228-860-4600
Mailing Address - Fax:888-974-3549
Practice Address - Street 1:2124 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3937
Practice Address - Country:US
Practice Address - Phone:228-860-4600
Practice Address - Fax:888-974-3549
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional