MEDICARE: MRS. ELIZABETH MACY ROGERS LPC, NCC, BCTMH

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	101YP2500X	Professional Counselor	1142	MS
2	101Y00000X	Counselor	1142	MS

General Provider Information

NPI Number	:	1841595378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH MACY ROGERS LPC, NCC, BCTMH

Provider Business Mailing Address
First Line	:	2124 GOVERNMENT ST
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3937
Country	:	US
Telephone Number	:	228-860-4600
Fax Number	:	888-974-3549

Provider Business Practice Location Address
First Line	:	2124 GOVERNMENT ST
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3937
Country	:	US
Telephone Number	:	228-860-4600
Fax Number	:	888-974-3549

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

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	10/30/2024

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