Individual
ANGELA ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-7121
(270) 443-9692
Mailing address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 994-5573
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
262003
KY
1041C0700X
Clinical Social Worker
256578
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100682490
—
KY
Enumeration date
12/02/2016
Last updated
12/27/2022
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