| Doctor Name: | JOHN ROGERS |
| NPI Number: | 1043526635 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA L.P.C.C. |
| License Number: | 00945 |
| Business Practice Address: | 5354 Parkdale Dr Suite 200 St Louis Park, MN - 554161603 |
| Business Phone Number: | 6516455323 |
| Business Fax Number: | |
| Mailing Address: | 5354 Parkdale Dr, Suite 200 ST LOUIS PARK |
| State: | MN |
| Postal Code: | 554161603 |
| Phone Number: | 6516455323 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2010 |
| NPI Last Update Date: | 05/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 00945 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |