Healthcare Provider Details

I. General information

NPI: 1710741145
Provider Name (Legal Business Name): EMILEE ROGERS BS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 FAIRVIEW ST
BRATTLEBORO VT
05301-6629
US

IV. Provider business mailing address

390 RIVER ST
SPRINGFIELD VT
05156-2226
US

V. Phone/Fax

Practice location:
  • Phone: 802-275-4971
  • Fax: 802-490-2378
Mailing address:
  • Phone: 802-886-4500
  • Fax: 802-886-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number097.0136189
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number097.0136189
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: