| Breanne Nicolle Rogers, CSW | |
|
1350 Us Highway 62 W, Princeton, KY 42445-6106 | |
| (270) 365-2008 | |
| Not Available |
| Full Name | Breanne Nicolle Rogers |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1350 Us Highway 62 W, Princeton, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841816428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 254996 (Kentucky) | Secondary |
| 1041C0700X | Social Worker - Clinical | 257406 (Kentucky) | Primary |
| Entity Name | Lifeskills, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669401816 PECOS PAC ID: 8820902638 Enrollment ID: O20031117000330 |
| Mailing Address | Practice Location Address |
|---|---|
| Breanne Nicolle Rogers, CSW Po Box 614, Hopkinsville, KY 42241-0614 Ph: (270) 886-2205 | Breanne Nicolle Rogers, CSW 1350 Us Highway 62 W, Princeton, KY 42445-6106 Ph: (270) 365-2008 |
Sonja Lee Ramey, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1350 Us Highway 62 W, Princeton, KY 42445 Phone: 270-365-2008 | |
Victoria Johnson Gray, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1350 Us Highway 62 W, Princeton, KY 42445 Phone: 270-365-2008 Fax: 270-365-2009 | |
Shandi Lynne Damron, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1350 Us Highway 62 W, Princeton, KY 42445 Phone: 270-365-2008 Fax: 270-365-2009 |