MEDICARE: ROGERS BEHAVIORAL HEALTH PRACTICE - PENNSYLVANIA, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2084P0804X	Child & Adolescent Psychiatry Physician
2	2084P0805X	Geriatric Psychiatry Physician
3	2084P0802X	Addiction Psychiatry Physician
4	103T00000X	Psychologist
5	363L00000X	Nurse Practitioner
6	101YP2500X	Professional Counselor
7	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist
8	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
9	103TC0700X	Clinical Psychologist
10	101YA0400X	Addiction (Substance Use Disorder) Counselor
11	2083A0300X	Addiction Medicine (Preventive Medicine) Physician
12	363LF0000X	Family Nurse Practitioner
13	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
14	363A00000X	Physician Assistant
15	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1932988839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROGERS BEHAVIORAL HEALTH PRACTICE - PENNSYLVANIA, P.C.

Provider Business Mailing Address
First Line	:	34700 VALLEY RD
Second Line	:
City	:	OCONOMOWOC
State	:	WI
Zip	:	53066-4500
Country	:	US
Telephone Number	:	800-767-4411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 WINDING DR STE 106
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2907
Country	:	US
Telephone Number	:	800-767-4411
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	CINDY MEYER
Credential	:	MSSW
Telephone Number	:	262-303-0580

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	01/20/2026

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