Provider Demographics
NPI:1801571773
Name:ROGERS, KIMBERLY KAY (LPC, NCC, MA, CAT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LPC, NCC, MA, CAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-9072
Mailing Address - Country:US
Mailing Address - Phone:203-387-9314
Mailing Address - Fax:
Practice Address - Street 1:9121 E 14TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-3057
Practice Address - Country:US
Practice Address - Phone:720-224-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health