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Kenneth Rogers
Peer Specialist in Fayetteville, North Carolina
NPI 1528458072

Kenneth Rogers is a Peer Specialist based in Fayetteville, NC. Kenneth Rogers practices in Fayetteville, NC. The NPI Number for Kenneth Rogers is 1528458072 and holds a License No. 2015213901 (North Carolina).

The current practice location address for Kenneth Rogers is 122 Bow St Ste A, Fayetteville, NC and can be reached out via phone at 919-675-6549.

Location: 122 Bow St Ste A, Fayetteville, NC, 28301-2308
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1528458072
Provider Name
Kenneth Rogers
Credential
Provider Entity Type
Individual
Gender
Male
Address
122 Bow St Ste A, Fayetteville, NC, 28301-2308
Phone Number
919-675-6549
Fax Number
Provider Enumeration Date
02/04/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
51144 01 NC DWI FACILITY CODE
institution
Provider Business Practice Location Address Details
Address
122 Bow St Ste A
City
Fayetteville
State
North Carolina
Zip
28301-2308
Phone Number
919-675-6549
Fax Number
person
Provider Business Mailing Address Details
Address
122 Bow St Ste A
City
Fayetteville
State
North Carolina
Zip
28301-2308
Phone Number
919-675-6549
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
2015213901 (North Carolina)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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