Healthcare Provider Details

I. General information

NPI: 1124661780
Provider Name (Legal Business Name): ROGERS' COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2443 LYNN RD STE 112
RALEIGH NC
27612-6759
US

IV. Provider business mailing address

2443 LYNN RD STE 112
RALEIGH NC
27612-6759
US

V. Phone/Fax

Practice location:
  • Phone: 984-280-2474
  • Fax: 919-891-6896
Mailing address:
  • Phone: 984-280-2474
  • Fax: 919-891-6896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY ROGERS
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LCMHCS,NCC,TFCBT
Phone: 919-586-4694