Healthcare Provider Details

I. General information

NPI: 1427135169
Provider Name (Legal Business Name): PAMELA ANNE ROGERS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMELA ANNE ROGERS-C'DE BACA

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 S SAINT FRANCIS DR STE E
SANTA FE NM
87505-4053
US

IV. Provider business mailing address

159 CALLE OJO FELIZ UNIT H
SANTA FE NM
87505-5791
US

V. Phone/Fax

Practice location:
  • Phone: 505-660-0443
  • Fax: 505-982-3948
Mailing address:
  • Phone: 505-660-0443
  • Fax: 505-983-6492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0089251
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: