Healthcare Provider Details

I. General information

NPI: 1093634719
Provider Name (Legal Business Name): KATRINA ROGERS LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRINA ROGERS

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 POPLAR AVE STE 302
MEMPHIS TN
38117-4433
US

IV. Provider business mailing address

3877 FUN VALLEY DR
MEMPHIS TN
38125-4643
US

V. Phone/Fax

Practice location:
  • Phone: 901-930-7397
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8723
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: