Provider Demographics
NPI:1851553846
Name:ROGERS, LINDA KAYE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:KAYE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SPRING VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-1950
Mailing Address - Country:US
Mailing Address - Phone:512-847-0634
Mailing Address - Fax:
Practice Address - Street 1:14 SPRING VALLEY DR
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-1950
Practice Address - Country:US
Practice Address - Phone:512-847-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX025981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical