Provider Demographics
NPI:1023809969
Name:BERGMANN-ROGERS, DONALD ARTHUR (LAC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ARTHUR
Last Name:BERGMANN-ROGERS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 S 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-5903
Mailing Address - Country:US
Mailing Address - Phone:480-761-7541
Mailing Address - Fax:
Practice Address - Street 1:2222 W PINNACLE PEAK RD STE 320
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1229
Practice Address - Country:US
Practice Address - Phone:480-761-7541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22966101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health