Healthcare Provider Details

I. General information

NPI: 1114209749
Provider Name (Legal Business Name): DAVID MICHAEL ROGERS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S WATER ST STE 230
HENDERSON NV
89015-7308
US

IV. Provider business mailing address

26 VIA VASARI UNIT 103
HENDERSON NV
89011-3730
US

V. Phone/Fax

Practice location:
  • Phone: 725-244-7223
  • Fax: 725-215-9766
Mailing address:
  • Phone: 725-244-7223
  • Fax: 725-215-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number00510-LC
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7739-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: