Provider Demographics
NPI:1538753694
Name:ROGERS, SIBYL (LCSW)
Entity type:Individual
Prefix:
First Name:SIBYL
Middle Name:
Last Name:ROGERS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 N LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PALO PINTO
Mailing Address - State:TX
Mailing Address - Zip Code:76484-3922
Mailing Address - Country:US
Mailing Address - Phone:940-329-1225
Mailing Address - Fax:
Practice Address - Street 1:1907 N LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:PALO PINTO
Practice Address - State:TX
Practice Address - Zip Code:76484-3922
Practice Address - Country:US
Practice Address - Phone:940-329-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX687941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1538753694OtherNPI