Provider Demographics
NPI:1952611931
Name:ROGISH, LIZA M A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:M A
Last Name:ROGISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GREENWOOD AVE STE 430
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2603
Mailing Address - Country:US
Mailing Address - Phone:215-703-7179
Mailing Address - Fax:
Practice Address - Street 1:101 GREENWOOD AVE STE 430
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2603
Practice Address - Country:US
Practice Address - Phone:215-703-7179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0805961041C0700X
PACW0183571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical