Provider Demographics
NPI:1871739094
Name:ROGERS, LAURA MILLS (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MILLS
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 GEORGIA BELLE CT
Mailing Address - Street 2:STE 2036
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-2667
Mailing Address - Country:US
Mailing Address - Phone:678-209-2745
Mailing Address - Fax:
Practice Address - Street 1:5030 GEORGIA BELLE CT
Practice Address - Street 2:STE 2036
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2667
Practice Address - Country:US
Practice Address - Phone:678-209-2745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW004841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health