Individual provider · Type 1 NPI

Derald Timothy Rogers Sr., LPC-MHSP ASSOCIATE

Mental Health Counselor · Ooltewah, TN

NPI number 1376448746 Active

Practice location

8029 Trout Lily Dr
Ooltewah, TN 37363-5781

Call (580) 222-6225 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X6902 (TN)

Mental Health Counselor: Definition to come...

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About NPI 1376448746

Derald Timothy Rogers Sr., LPC-MHSP ASSOCIATE's National Provider Identifier is 1376448746, issued on Oct 13, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Ooltewah, TN. The record was last updated on Oct 13, 2026.