Provider Demographics
NPI:1336346998
Name:ROGERS, HELEN JOHNSON (PHD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:JOHNSON
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 TURKEY FARM RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-7903
Mailing Address - Country:US
Mailing Address - Phone:919-968-8070
Mailing Address - Fax:
Practice Address - Street 1:5425 TURKEY FARM RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-7903
Practice Address - Country:US
Practice Address - Phone:919-968-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1685103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC04457OtherBLUE CROSS BLUE SHIELD NC