Provider Demographics
NPI:1467296202
Name:ROGERS, SHAUNTE MONIQUE (LPC)
Entity type:Individual
Prefix:
First Name:SHAUNTE
Middle Name:MONIQUE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 N CANFIELD NILES RD STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2341
Mailing Address - Country:US
Mailing Address - Phone:330-953-7551
Mailing Address - Fax:
Practice Address - Street 1:60 N CANFIELD NILES RD STE 700
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2341
Practice Address - Country:US
Practice Address - Phone:330-953-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1800883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health