MEDICARE: JODELL ROGERS LCSW

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
1	101Y00000X	Counselor	09932396	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09932396	OTHER	CO	LCSW

General Provider Information

NPI Number	:	1093442063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODELL ROGERS LCSW

Provider Business Mailing Address
First Line	:	301 E OLIVE ST
Second Line	:
City	:	LAMAR
State	:	CO
Zip	:	81052-2840
Country	:	US
Telephone Number	:	719-931-9844
Fax Number	:	719-931-8007

Provider Business Practice Location Address
First Line	:	310 E OLIVE ST
Second Line	:
City	:	LAMAR
State	:	CO
Zip	:	81052-2841
Country	:	US
Telephone Number	:	719-931-9844
Fax Number	:	719-931-8007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	02/04/2026

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Directions to “ JODELL ROGERS LCSW” Practice Location

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