MEDICARE: MR. AUSTIN ROGERS LMHC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1154660496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AUSTIN ROGERS LMHC

Provider Business Mailing Address
First Line	:	1029 NORTH RD # 152
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-9711
Country	:	US
Telephone Number	:	413-351-8200
Fax Number	:	413-460-5760

Provider Business Practice Location Address
First Line	:	1029 NORTH RD # 152
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-9711
Country	:	US
Telephone Number	:	413-351-8200
Fax Number	:	413-460-5760

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

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	09/18/2023

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