Licia Williams Rogers, LPA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1980 Issued in NC

Practice address

4020 Oleander Dr Ste 203
Wilmington, NC 28403-6850

Phone

(910) 540-8081

Fax

(910) 399-3434

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Carenet, Inc.

  • Mental Health Counselor
  • North Wilkesboro, NC
  • NPI 1598235087
  NPD (past)
• Carenet, Inc.

  • Mental Health Counselor
  • North Wilkesboro, NC
  • NPI 1760696736
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1912098260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 OLEANDER DR STE 203",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036850",
            "telephone_number": "910-540-8081",
            "fax_number": "910-399-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 OLEANDER DR STE 203",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036850",
            "telephone_number": "910-540-8081",
            "fax_number": "910-399-3434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Tarpon Trl",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285465287",
            "country_code": "US",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LICIA",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1980",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "1980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107193",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda R Rogers, APN
• Elizabeth B Rogers, MPH, PT
• Erin Page Rogers, R.PH.
• Kimberly Dowless Rogers, RN, CDCES
• Kristen Rogers
• Miranda Rogers, BCBA
• Pamela M Rogers, NPC
• Carla Dibenedetto Rohena, PA
• Melanie Rezende Rojas, MD
• Alison Roller-Alling, PMHNP-BC

• Clinical Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.