Provider Demographics
NPI:1386696037
Name:ROGERS, JILL L (LPC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:L
Other - Last Name:ZIKMUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:60 STRAWBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146
Mailing Address - Country:US
Mailing Address - Phone:724-699-9056
Mailing Address - Fax:724-558-9559
Practice Address - Street 1:60 STRAWBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146
Practice Address - Country:US
Practice Address - Phone:724-699-9056
Practice Address - Fax:724-558-9559
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102576680-0001Medicaid