Provider Demographics
NPI:1689284051
Name:ROGERS, JAMES DOUGLAS (LMHC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DOUGLAS
Last Name:ROGERS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 STUBBINGTON LN # IN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-1598
Mailing Address - Country:US
Mailing Address - Phone:317-662-0095
Mailing Address - Fax:
Practice Address - Street 1:4107 STUBBINGTON LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-1598
Practice Address - Country:US
Practice Address - Phone:317-662-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004174A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health