Provider Demographics
NPI:1336213768
Name:ROGERS, DAVID MCCAIN (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MCCAIN
Last Name:ROGERS
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 54TH ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4837
Mailing Address - Country:US
Mailing Address - Phone:917-514-5654
Mailing Address - Fax:
Practice Address - Street 1:220 E 54TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4837
Practice Address - Country:US
Practice Address - Phone:917-514-5654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-18
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047449-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical