Active NPI
Kylie Rogalla, PH.D., LPC, NCC
- Professional Counselor
- South Bend, IN
National Provider Identifier
1497398762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 22355 Applewood LN
South Bend, IN 46628-9708 - Phone
- (507) 993-6766
- NPI assigned
- Oct 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
22355 Applewood LN
South Bend, IN 46628-9708
Mailing address
22355 Applewood LN
South Bend, IN 46628-9708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571443200000",
"number": "1497398762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22355 APPLEWOOD LN",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466289708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22355 APPLEWOOD LN",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466289708",
"telephone_number": "507-993-6766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGALLA",
"first_name": "KYLIE",
"name_prefix": "Dr.",
"credential": "PH.D., LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-19",
"last_updated": "2019-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.