Provider Demographics
NPI:1124840442
Name:ROGERS, CHRISTY MICHELLE (DSW, MSW, LISW-CP)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:MICHELLE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DSW, MSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BLAIRHUNT DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4324
Mailing Address - Country:US
Mailing Address - Phone:864-905-4870
Mailing Address - Fax:
Practice Address - Street 1:2 BLAIRHUNT DR
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-4324
Practice Address - Country:US
Practice Address - Phone:864-905-4870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC49661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical