Provider Demographics
NPI:1992870919
Name:ROGERS, KATE DAVIS (LPCC, LPAT)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:DAVIS
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPCC, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 SAN MATEO BLVD NE
Mailing Address - Street 2:SUITE S-15
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4058
Mailing Address - Country:US
Mailing Address - Phone:505-238-8405
Mailing Address - Fax:505-281-8001
Practice Address - Street 1:2403 SAN MATEO BLVD NE
Practice Address - Street 2:SUITE S-15
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4058
Practice Address - Country:US
Practice Address - Phone:505-238-8405
Practice Address - Fax:505-281-8001
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional