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General NPI Number Information
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NPI Number | 1730425018
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Entity Type | Individual
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Provider Name | LAKEISHA G ROGERS PHD, LCMHC, LCAS,CRC
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Gender | Female
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 5 CENTERVIEW DR SUITE 110
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City | GREENSBORO
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State | NC
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Zip | 27407
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Country | US
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Telephone | 336-663-8017
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Fax | 336-232-9454
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Provider Business Mailing Address
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Address Line | 1 KENTBURY CIR # 215
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City | GREENSBORO
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State | NC
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Zip | 27406-9340
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Country | US
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Telephone | 336-663-8017
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Fax | 336-232-9454
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2718
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10662
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License Number State | NC
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