Healthcare Provider Details

I. General information

NPI: 1922434026
Provider Name (Legal Business Name): RACHEL A. ROGERS THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4482 PERCIVAL RD
ROCK HILL SC
29730-9281
US

IV. Provider business mailing address

4482 PERCIVAL RD
ROCK HILL SC
29730-9281
US

V. Phone/Fax

Practice location:
  • Phone: 803-389-4131
  • Fax:
Mailing address:
  • Phone: 803-389-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5186
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: