Provider Demographics
NPI:1124819677
Name:ROGERS, KELBIE (LPC-A)
Entity type:Individual
Prefix:
First Name:KELBIE
Middle Name:
Last Name:ROGERS
Suffix:
Gender:
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 LORALINDA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5845
Mailing Address - Country:US
Mailing Address - Phone:512-201-4501
Mailing Address - Fax:
Practice Address - Street 1:8500 SHOAL CREEK BLVD # 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7591
Practice Address - Country:US
Practice Address - Phone:512-201-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health