Doctor Name: | MS. LISE G ROGERS |
NPI Number: | 1861552267 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, NCC |
License Number: | 1999135684 |
Business Practice Address: | 202 Nw 11th St Ava, MO - 65608 |
Business Phone Number: | 4174255533 |
Business Fax Number: | 4177256206 |
Mailing Address: | 1978 W Buena Vista St, SPRINGFIELD |
State: | MO |
Postal Code: | 658101515 |
Phone Number: | 4174255533 |
Fax Number: | 4177256206 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1999135684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |