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General NPI Number Information
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NPI Number | 1629730155
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Entity Type | Organization
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Legal Business Name | ROGERS MENTAL HEALTH AND WELLNESS, PLLC
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | OLD DOLLARWAY ROAD SUITE 1
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City | WHITE HALL
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State | AR
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Zip | 71602-7160
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Country | US
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Telephone | 479-970-7981
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N RED ST
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City | SHERIDAN
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State | AR
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Zip | 72150-8005
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Country | US
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Telephone | 479-970-8393
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Fax |
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Authorized Official
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Title or Position | INCORPORATOR
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Name | MRS. BRANDI ROGERS
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Credential | LCSW
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Telephone | 479-970-8393
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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 |
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License Number State |
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