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General NPI Number Information
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NPI Number | 1003115874
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Entity Type | Individual
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Provider Name | DAVID JAMES ROGERS LPC
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Gender | Male
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Dates
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Enumeration Date | 03/20/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 10426 SUMMER HILL RD
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-6613
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Country | US
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Telephone | 804-922-1486
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 PUMP RD SUITE 220
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City | RICHMOND
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State | VA
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Zip | 23233-3539
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Country | US
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Telephone | 804-922-1486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004611
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License Number State | VA
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