1548653843 NPI number — ROGERS COUNSELING SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548653843 NPI number — ROGERS COUNSELING SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROGERS COUNSELING SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1548653843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2303 W BEACON CIRCLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROGERS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72758-6433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-957-8464
Provider Business Mailing Address Fax Number:
479-936-8196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2303 W BEACON CIRCLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROGERS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72758-6433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-957-8464
Provider Business Practice Location Address Fax Number:
479-936-8196
Provider Enumeration Date:
03/10/2015

Additional Information

Authorized Official

Authorized Official Last Name:
LYON
Authorized Official First Name:
CYNDIE
Authorized Official Middle Name:
LUE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
479-957-8464

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C-977 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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