MEDICARE: JAMES DOUGLAS 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	39004174A	IN

General Provider Information

NPI Number	:	1689284051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DOUGLAS ROGERS LMHC

Provider Business Mailing Address
First Line	:	PO BOX 844715
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64184-4715
Country	:	US
Telephone Number	:	417-761-5214
Fax Number	:	417-761-5065

Provider Business Practice Location Address
First Line	:	234 E SOUTHERN AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46225-2121
Country	:	US
Telephone Number	:	317-882-5122
Fax Number	:	317-888-8642

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

Provider Enumeration Date	:	07/31/2020
Last Update Date	:	05/06/2026

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