Healthcare Provider Details

I. General information

NPI: 1083171771
Provider Name (Legal Business Name): ROGERS CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 W 6TH AVE
PINE BLUFF AR
71601-4031
US

IV. Provider business mailing address

PO BOX 1926
PINE BLUFF AR
71613-1926
US

V. Phone/Fax

Practice location:
  • Phone: 870-568-4502
  • Fax: 870-395-7086
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TEMIKA RONNECCHIA ROGERS
Title or Position: THEARPIST
Credential: LCSW
Phone: 870-718-2349