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NPI Code Detail

MEDICARE: LISA RENEE RODGERS LPC

MEDICARE: LISA RENEE RODGERS LPC
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
1101YP2500XProfessional CounselorLPC010447GA
2101YP2500XProfessional CounselorC.0007729OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000488649OTHEROHANTHEM BLUE CROSS PIN

General Provider Information

NPI Number : 1518026038
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA RENEE RODGERS LPC
Provider Business Mailing Address
First Line : 1899 POWERS FERRY RD SE FL 2
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5620
Country : US
Telephone Number : 678-831-0608
Fax Number : 678-831-0564
Provider Business Practice Location Address
First Line : 1899 POWERS FERRY RD SE FL 2
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5620
Country : US
Telephone Number : 678-831-0608
Fax Number : 678-831-0564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 03/03/2026

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Directions to “ LISA RENEE RODGERS LPC” Practice Location

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