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NPI Code Detail

MEDICARE: MINA RODGERS LPC, NCC

MEDICARE: MINA RODGERS LPC, NCC
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 CounselorLPC013787GA
2101YM0800XMental Health CounselorLPC013787GA

General Provider Information

NPI Number : 1912695222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINA RODGERS LPC, NCC
Provider Business Mailing Address
First Line : 3633 WHEELER RD # 365
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6549
Country : US
Telephone Number : 678-778-6089
Fax Number :
Provider Business Practice Location Address
First Line : 4039 GATEWAY BLVD
Second Line :
City : GROVETOWN
State : GA
Zip : 30813-3389
Country : US
Telephone Number : 706-498-9570
Fax Number : 678-369-5762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2023
Last Update Date : 03/16/2026

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Directions to “ MINA RODGERS LPC, NCC” Practice Location

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