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General NPI Number Information
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NPI Number | 1639992969
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Entity Type | Individual
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Provider Name | JEFFREY ROGERS LMSW
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Gender | Male
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 2573 STATE HIGHWAY 522
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City | QUESTA
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State | NM
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Zip | 87556
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Country | US
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Telephone | 575-586-0331
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Fax | 505-443-8353
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Provider Business Mailing Address
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Address Line | 2573 STATE HIGHWAY 522
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City | QUESTA
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State | NM
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Zip | 87556
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Country | US
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Telephone | 575-586-0331
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Fax | 505-443-8353
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWB-2025-0572
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License Number State | NM
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