Provider Demographics
NPI:1518400860
Name:ROGERS, WILLIAM (LMFT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 FLAX HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2405
Mailing Address - Country:US
Mailing Address - Phone:203-855-7566
Mailing Address - Fax:
Practice Address - Street 1:325 FLAX HILL RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-2405
Practice Address - Country:US
Practice Address - Phone:203-855-7566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist