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General NPI Number Information
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NPI Number | 1255299293
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Entity Type | Individual
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Provider Name | SHANNON SHAWNDRECE ROGERS
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Gender | Female
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 8 SOUTHPOINTE DR
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City | PARAGOULD
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State | AR
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Zip | 72450-6238
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Country | US
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Telephone | 870-565-1111
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Fax | 870-565-1112
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Provider Business Mailing Address
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Address Line | 200 N 18TH AVE
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City | PARAGOULD
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State | AR
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Zip | 72450-4726
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Country | US
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Telephone | 870-476-6964
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Fax | 870-565-1112
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5473-M
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License Number State | AR
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