Provider Demographics
NPI:1164882155
Name:PIERCE, ROGER (MA, LMHC, LCPC)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:PIERCE
Suffix:
Gender:M
Credentials:MA, LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 S CLEARWATER LOOP, STE 8049
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9599
Mailing Address - Country:US
Mailing Address - Phone:206-691-8900
Mailing Address - Fax:206-316-8399
Practice Address - Street 1:784 S CLEARWATER LOOP, STE 8049
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854
Practice Address - Country:US
Practice Address - Phone:206-691-8900
Practice Address - Fax:206-316-8399
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61362349101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health