Wanda Ann Rogers, MA, EDD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401011542 Issued in MI

Practice address

1028 Cass Ave SE
Grand Rapids, MI 49507-1120

Phone

(616) 241-3396

NPI assigned

Jun 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Wanda Ann Banks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Reconciliation of Life

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1942739156
  NPD (past) Authorized official

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

{
    "created_epoch": "1497052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497052800000",
    "number": "1659800878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 CASS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071120",
            "telephone_number": "616-241-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 CASS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071120",
            "telephone_number": "616-241-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "WANDA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MA, EDD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-10",
        "last_updated": "2017-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "BANKS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marissa Rogers
• Michael Scott Rogers, PT
• Rachel Ann Rogers, P.A.
• Terreya Rogers
• Virginia Paige Rogers, LMSW
• Amy Rogghe, PA-C
• Brittni Simonti Rohde, M.D.
• Miranda Lynn Rohde
• Mackenzie Jane Rohm
• Fred A Rohn, M.D.

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.