Provider Demographics
NPI:1669895165
Name:ROGINSKY, YEVGENY B (LCSW)
Entity type:Individual
Prefix:
First Name:YEVGENY
Middle Name:B
Last Name:ROGINSKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:EUGENE
Other - Middle Name:B
Other - Last Name:ROGINSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:818 SWALLOW ST
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3651
Mailing Address - Country:US
Mailing Address - Phone:847-975-2331
Mailing Address - Fax:224-676-0848
Practice Address - Street 1:1020 MILWAUKEE AVE STE 235
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3555
Practice Address - Country:US
Practice Address - Phone:847-975-2331
Practice Address - Fax:224-676-0848
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490089101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical