1831208024 NPI number — MS. JANET ELAINE ROGERS LSCSW

Table of content: MS. JANET ELAINE ROGERS LSCSW (NPI 1831208024)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831208024 NPI number — MS. JANET ELAINE ROGERS LSCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROGERS
Provider First Name:
JANET
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSCSW
Provider Gender Code:
F

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:
1831208024
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6220 W CASTLETON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRETTY PRAIRIE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67570-8508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-459-6925
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1716 E. 30TH
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HUTCHINSON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67502-1230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-669-8700
Provider Business Practice Location Address Fax Number:
620-669-8706
Provider Enumeration Date:
08/30/2006

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: 1041C0700X , with the licence number:  1160 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 281341 . This is a "VALUE OPTIONS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 247063000 . This is a "MEGELLAN HEALTH CARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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