Provider Demographics
NPI:1396382362
Name:ROGERS, BETTY JEAN (MA)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1193
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29679-1193
Mailing Address - Country:US
Mailing Address - Phone:864-280-4911
Mailing Address - Fax:
Practice Address - Street 1:602 AIRPORT RD STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2617
Practice Address - Country:US
Practice Address - Phone:864-234-7952
Practice Address - Fax:864-234-7985
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist