DERALD TIMOTHY ROGERS LPC-MHSP ASSOCIATE NPI 1376448746

NPI Information

  • NPI: 1376448746
  • Provider Name: DERALD TIMOTHY ROGERS, LPC-MHSP ASSOCIATE
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 8029 TROUT LILY DR
    OOLTEWAH, TN
    ZIP 37363
  • Phone: (580) 222-6225

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NPI Details

Derald Timothy Rogers, LPC-MHSP ASSOCIATE is a mental health counselor in Ooltewah, TN. Derald Timothy Rogers, LPC-MHSP ASSOCIATE NPI is 1376448746. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8029 TROUT LILY DR
OOLTEWAH, TN
ZIP 37363-781
Phone: (580) 222-6225

The enumeration date for this NPI number is 10/13/2026 and was last updated on 10/13/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health6902TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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