Healthcare Provider Details

I. General information

NPI: 1104694652
Provider Name (Legal Business Name): KATIE ROGERS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 FRANKLIN ST
CEDAR FALLS IA
50613-2746
US

IV. Provider business mailing address

4202 BRIARWOOD DR
CEDAR FALLS IA
50613-7518
US

V. Phone/Fax

Practice location:
  • Phone: 319-214-5626
  • Fax:
Mailing address:
  • Phone: 319-551-0595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATIE JO ROGERS
Title or Position: SOLE MEMBER
Credential:
Phone: 319-551-0595