Individual provider Active NPI

Sally Ann Rogers, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
National Provider Identifier
1699058743
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1480 Issued in NC
Practice address
3303 Latrobe Dr
Charlotte, NC 28211-4851
Phone
(704) 362-2663
Fax
(704) 362-2836
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1480 NC Primary

Addresses

Primary practice location

3303 Latrobe Dr
Charlotte, NC 28211-4851

Mailing address

3303 Latrobe Dr
Charlotte, NC 28211-4851
Phone (704) 362-2663

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
1480NCMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1699058743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114851",
            "telephone_number": "704-362-2663",
            "fax_number": "704-362-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114851",
            "telephone_number": "704-362-2663",
            "fax_number": "704-362-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.