| Kelene Rogers, Llc | |
|
4386 Autumn Joy St Galesburg MI 49053-7700 | |
| (269) 806-2105 | |
| Not Available |
| Full Name | Kelene Rogers, Llc |
|---|---|
| Speciality | Counselor |
| Location | 4386 Autumn Joy St, Galesburg, Michigan |
| Authorized Official Name and Position | Kelene Rogers (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2698062105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelene Rogers, Llc Po Box 581 Richland MI 49083-0581 Ph: () - | Kelene Rogers, Llc 4386 Autumn Joy St Galesburg MI 49053-7700 Ph: (269) 806-2105 |
| NPI Number | 1447828108 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 06/17/2021 |
| Certification Date | 06/17/2021 |
| Medicare PECOS PAC ID | 7012369465 |
|---|---|
| Medicare Enrollment ID | O20240122001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447828108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelene Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134548647 PECOS PAC ID: 8921450370 Enrollment ID: I20240122001421 |
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