Provider Demographics
NPI:1033459516
Name:RODRIGUEZ, MARLENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:
Last Name:RODRIGUEZ
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 1:653 W EDGAR RD # 1046
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-6574
Mailing Address - Country:US
Mailing Address - Phone:908-248-4459
Mailing Address - Fax:
Practice Address - Street 1:653 W EDGAR RD # 1046
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-6574
Practice Address - Country:US
Practice Address - Phone:908-248-4459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL057329001041C0700X
NJ44SC055925001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical