Provider Demographics
NPI:1447360748
Name:ROGOZINSKI, MARTIN JOSEPH (MA, LPC, LSATP)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:JOSEPH
Last Name:ROGOZINSKI
Suffix:
Gender:M
Credentials:MA, LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 ARROWHEAD TRL
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-3161
Mailing Address - Country:US
Mailing Address - Phone:540-260-9055
Mailing Address - Fax:540-260-9055
Practice Address - Street 1:125 ARROWHEAD TRL
Practice Address - Street 2:SUITE B
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-3161
Practice Address - Country:US
Practice Address - Phone:540-260-9055
Practice Address - Fax:540-260-9055
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000063101YA0400X
VA0701002535101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional