1487007878 NPI number — MR. ARLIE FRANKLIN ROGERS JR. MA, LPC-INTERN, NCC

Table of content: MR. ARLIE FRANKLIN ROGERS JR. MA, LPC-INTERN, NCC (NPI 1487007878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487007878 NPI number — MR. ARLIE FRANKLIN ROGERS JR. MA, LPC-INTERN, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROGERS
Provider First Name:
ARLIE
Provider Middle Name:
FRANKLIN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
MA, LPC-INTERN, NCC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487007878
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6777 ISLAND DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75054-6807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
682-233-1661
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 WESTWAY PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76018-5245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
682-233-1661
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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