Provider Demographics
NPI:1194962092
Name:ROGERS, MELANIE BAKER (LPC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:BAKER
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 FAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-4060
Mailing Address - Country:US
Mailing Address - Phone:304-290-7210
Mailing Address - Fax:304-381-2456
Practice Address - Street 1:874 FAIRMONT RD
Practice Address - Street 2:SUITE C
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-0086
Practice Address - Country:US
Practice Address - Phone:304-290-7210
Practice Address - Fax:304-381-2456
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health