Provider Demographics
NPI:1427511344
Name:ROGERS, CHRISTINA (MA, LMHC, LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MA, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 PASADENA AVE S STE 327G
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-6425
Mailing Address - Country:US
Mailing Address - Phone:727-851-9100
Mailing Address - Fax:
Practice Address - Street 1:1135 PASADENA AVE S STE 327G
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-6425
Practice Address - Country:US
Practice Address - Phone:727-851-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00696800101YM0800X
FL16393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty