Individual provider Active NPI

Traci Brenner Rogers, LPC

  • Professional Counselor
  • Mechanicsburg, PA
National Provider Identifier
1689952053
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC005955 Issued in PA
Practice address
5249 Simpson Ferry Rd
Mechanicsburg, PA 17050-3515
Phone
(717) 487-5493
Fax
(717) 790-9268
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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 PC005955 PA Primary

Addresses

Primary practice location

5249 Simpson Ferry Rd
Mechanicsburg, PA 17050-3515

Mailing address

138 Stonebridge Dr
Dillsburg, PA 17019-8309
Phone (443) 907-9074

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

State licenses

LicenseStateTypeSpecialty
PC005955PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Counseling of Central Penn Professional CurrentSince Aug 6, 2019 Accepting new patients
Pressley Ridge Past Accepting new patients

Locations

5249 Simpson Ferry Rd
Mechanicsburg, PA 17050
Phone (717) 487-5493

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1689952053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 STONEBRIDGE DR",
            "city": "DILLSBURG",
            "state": "PA",
            "postal_code": "170198309",
            "telephone_number": "443-907-9074",
            "fax_number": "717-790-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 SIMPSON FERRY RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503515",
            "telephone_number": "717-487-5493",
            "fax_number": "717-790-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TRACI",
        "middle_name": "BRENNER",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.

Verify at the official NPI Registry.