Provider Demographics
NPI:1336377894
Name:ROGERS, CHERYL L (LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 GREEN OAK PL
Mailing Address - Street 2:SUITE #208
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2057
Mailing Address - Country:US
Mailing Address - Phone:713-292-3265
Mailing Address - Fax:
Practice Address - Street 1:1521 GREEN OAK PL
Practice Address - Street 2:SUITE #208
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2057
Practice Address - Country:US
Practice Address - Phone:713-292-3265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62968101YP2500X
TX201093106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional