Provider Demographics
NPI:1174514301
Name:ROGERS, CHARLOTTE M (LPC)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:M
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20508 BARGENE WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1157
Mailing Address - Country:US
Mailing Address - Phone:301-972-3651
Mailing Address - Fax:
Practice Address - Street 1:1325 QUINCY ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2615
Practice Address - Country:US
Practice Address - Phone:202-526-4445
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC1352101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
35179OtherNATIONAL COUNSELOR
MDLC0860OtherLICENSED COUNSELOR
DCPRC1352OtherLICENSED COUNSELOR