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General NPI Number Information
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NPI Number | 1215563424
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Entity Type | Organization
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Legal Business Name | DR. DAVID ROGERS, PHD LTD.
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 1180 N TOWN CENTER DR STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89144-6308
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Country | US
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Telephone | 702-830-5220
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 N TOWN CENTER DR STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89144-6308
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Country | US
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Telephone | 702-830-5220
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Fax |
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Authorized Official
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Title or Position | OWNER, LICENSED THERAPIST
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Name | DR. DAVID M ROGERS
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Credential | PHD, LCSW, LC-S
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Telephone | 702-324-0221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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