Individual provider Active NPI

Tiffany Shanette Rogers, LCMHCS

  • Professional Counselor
  • Raleigh, NC
National Provider Identifier
1316345242
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
S12780 Issued in NC
Practice address
2443 Lynn Rd Ste 112
Raleigh, NC 27612-6759
Phone
(984) 280-2474
Fax
(919) 891-6896
NPI assigned
Dec 9, 2014
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X S12780 NC Primary

Addresses

Primary practice location

2443 Lynn Rd Ste 112
Raleigh, NC 27612-6759

Mailing address

2443 Lynn Rd Ste 112
Raleigh, NC 27612-6759
Phone (984) 280-2474

Other identifiers 1

IdentifierTypeStateIssuer
$$$$$$$$$MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314003120 NC Practitioner - Mental Health Counselor 1254777006 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S12780NCMDProfessional Counselor
12780NCMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers' Counseling Services PLLC Addiction (Substance Use Disorder) CurrentSince Jan 30, 2024 Accepting new patients

Locations

2443 Lynn Rd
Ste 112
Raleigh, NC 27612
Phone (919) 438-4060

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1316345242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 LYNN RD STE 112",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126759",
            "telephone_number": "984-280-2474",
            "fax_number": "919-891-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 LYNN RD STE 112",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126759",
            "telephone_number": "984-280-2474",
            "fax_number": "919-891-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TIFFANY",
        "middle_name": "SHANETTE",
        "name_prefix": "Mrs.",
        "credential": "LCMHCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "S12780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.