MEDICARE: CASSANDRA BERRY-ROGERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	S19987805	MA

General Provider Information

NPI Number	:	1568904753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA BERRY-ROGERS

Provider Business Mailing Address
First Line	:	5 PARK RD
Second Line	:
City	:	LYNN
State	:	MA
Zip	:	01904-1609
Country	:	US
Telephone Number	:	978-809-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 PARK RD
Second Line	:
City	:	LYNN
State	:	MA
Zip	:	01904-1609
Country	:	US
Telephone Number	:	978-809-1332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2016
Last Update Date	:	03/03/2026

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Directions to “ CASSANDRA BERRY-ROGERS ” Practice Location

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