=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538970421
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA THOMASEE ROGERS MENTAL HEALTH COACH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2025
-----------------------------------------------------
Last Update Date | 01/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7865 JEFFERSON HWY STE D
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70809-1384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-757-6667
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3128 HARRELLS LANE DRIVE
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-266-2759
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | DIPLOMA
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------