Individual
ALEXIS RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
939 JOHNSON AVE, RONKONKOMA, NY 11779-6066
(631) 471-7242
Mailing address
132 HALESITE DR, SOUND BEACH, NY 11789-1942
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
080139
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249145
—
NY
Enumeration date
06/02/2008
Last updated
12/22/2016
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