Provider Demographics
NPI:1205998028
Name:ROGAN, ERICA ELIZABETH (MA)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:ELIZABETH
Last Name:ROGAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 OSCEOLA AVENUE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606
Mailing Address - Country:US
Mailing Address - Phone:508-365-7566
Mailing Address - Fax:
Practice Address - Street 1:337 MAIN STREET
Practice Address - Street 2:SUITE 320 SOUTH BAY MENTAL HEALTH
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-752-3969
Practice Address - Fax:508-752-3967
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator