Healthcare Provider Details

I. General information

NPI: 1609267483
Provider Name (Legal Business Name): MELINDA ROGERS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2015
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30752 SOUTHVIEW DR STE 200
EVERGREEN CO
80439-2221
US

IV. Provider business mailing address

30752 SOUTHVIEW DR STE 200
EVERGREEN CO
80439-2221
US

V. Phone/Fax

Practice location:
  • Phone: 720-765-5972
  • Fax: 469-444-6033
Mailing address:
  • Phone: 720-765-5972
  • Fax: 469-444-6033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number100568
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2025-0168
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0004133
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: