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General NPI Number Information
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NPI Number | 1710979414
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Entity Type | Individual
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Provider Name | JAMES S ROGERS JR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 1616 S KENTUCKY ST SUITE 125A
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City | AMARILLO
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State | TX
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Zip | 79102-2250
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Country | US
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Telephone | 806-463-7001
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Fax | 806-463-7006
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Provider Business Mailing Address
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Address Line | 1616 S KENTUCKY ST SUITE 125A
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City | AMARILLO
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State | TX
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Zip | 79102-2252
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Country | US
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Telephone | 806-463-7001
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Fax | 806-463-7006
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6087
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10387
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License Number State | TX
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