Healthcare Provider Details

I. General information

NPI: 1952398091
Provider Name (Legal Business Name): BEVERLY E ROGERS PHD, LCMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 POYNTZ AVE
MANHATTAN KS
66502-4145
US

IV. Provider business mailing address

1408 POYNTZ AVE
MANHATTAN KS
66502-4145
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-4105
  • Fax: 785-537-2299
Mailing address:
  • Phone: 785-776-4105
  • Fax: 785-537-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number051
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1223
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: