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General NPI Number Information
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NPI Number | 1689227878
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Entity Type | Individual
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Provider Name | HEIDI LYNN ROGERS LCSW, ACADC
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Gender | Female
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Dates
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Enumeration Date | 07/17/2019
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 847 PARKCENTRE WAY STE 3
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City | NAMPA
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State | ID
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Zip | 83651-1794
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Country | US
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Telephone | 208-901-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 AIRPORT RD
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City | NAMPA
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State | ID
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Zip | 83687-8656
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Country | US
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Telephone | 208-249-7894
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Fax |
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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 | 8911164
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5085
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13033
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License Number State | ID
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