Healthcare Provider Details

I. General information

NPI: 1124645288
Provider Name (Legal Business Name): MARTIN-ROGERS COUNSELING AND CONSULTATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 S WALL ST
COLUMBUS OH
43206-1921
US

IV. Provider business mailing address

855 S WALL ST
COLUMBUS OH
43206-1921
US

V. Phone/Fax

Practice location:
  • Phone: 614-212-4724
  • Fax:
Mailing address:
  • Phone: 614-212-4724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA ROGERS
Title or Position: OWNER/MEMBER
Credential: LISW-S
Phone: 614-212-4712