Healthcare Provider Details

I. General information

NPI: 1255258422
Provider Name (Legal Business Name): JOANN ELAINE ROGERS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 PALOMINO CT
LAGRANGE OH
44050-9642
US

IV. Provider business mailing address

372 PALOMINO CT
LAGRANGE OH
44050-9642
US

V. Phone/Fax

Practice location:
  • Phone: 440-864-7703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1201310
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: