Provider Demographics
NPI:1720819758
Name:RODGERS PROFESSIONAL SERVICES LLC
Entity type:Organization
Organization Name:RODGERS PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-201-0122
Mailing Address - Street 1:5368 PINEYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3423
Mailing Address - Country:US
Mailing Address - Phone:205-201-0122
Mailing Address - Fax:
Practice Address - Street 1:4800 VALLEYDALE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4611
Practice Address - Country:US
Practice Address - Phone:205-201-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty