Provider Demographics
NPI:1689169823
Name:ROGERSON, MEREDITH SARGENT (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:SARGENT
Last Name:ROGERSON
Suffix:
Gender:
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BROAD ST STE 14134
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4301
Mailing Address - Country:US
Mailing Address - Phone:617-807-0730
Mailing Address - Fax:
Practice Address - Street 1:56 BROAD ST STE 14134
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4301
Practice Address - Country:US
Practice Address - Phone:617-807-0730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1218541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical