Provider Demographics
NPI:1124844105
Name:ROGERS, KATHRYN (LSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 ROADS END PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2841
Mailing Address - Country:US
Mailing Address - Phone:614-561-1444
Mailing Address - Fax:
Practice Address - Street 1:807 KINNEAR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1490
Practice Address - Country:US
Practice Address - Phone:614-687-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2208217104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker