Provider Demographics
NPI:1679886352
Name:ROGERS, CATHERINE GINGER (LMHC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:GINGER
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SAINT GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-5159
Mailing Address - Country:US
Mailing Address - Phone:407-406-2425
Mailing Address - Fax:
Practice Address - Street 1:116 SAINT GEORGE RD
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-5159
Practice Address - Country:US
Practice Address - Phone:407-406-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health