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NPI Code Detail

MEDICARE: MELANIE B ROGERS LLC

MEDICARE: MELANIE B ROGERS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)2265-3303WV

General Provider Information

NPI Number : 1073027371
Entity Type Code : Organization
Provider Name (Legal Business Name) : MELANIE B ROGERS LLC
Provider Business Mailing Address
First Line : 748 FAIRMONT RD
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-4060
Country : US
Telephone Number : 304-290-7210
Fax Number : 304-381-2456
Provider Business Practice Location Address
First Line : 748 FAIRMONT RD
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-4060
Country : US
Telephone Number : 304-290-7210
Fax Number : 304-381-2456
Authorized Official
Title or Position : OWNER/MANAGER
Name : MELANIE ROGERS
Credential : LPC
Telephone Number : 304-290-7210
Provider Enumeration Date : 11/22/2017
Last Update Date : 03/17/2018

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Directions to “MELANIE B ROGERS LLC ” Practice Location

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