Provider Demographics
NPI:1093252587
Name:BRIGIDA RODRIGUEZ COUNSELING SERVICES CORP
Entity Type:Organization
Organization Name:BRIGIDA RODRIGUEZ COUNSELING SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMEBER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGIDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-898-5184
Mailing Address - Street 1:52 CASTLE RUN DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1416
Mailing Address - Country:US
Mailing Address - Phone:302-898-5184
Mailing Address - Fax:302-257-5621
Practice Address - Street 1:5155 W WOODMILL DR
Practice Address - Street 2:SUITE17
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4067
Practice Address - Country:US
Practice Address - Phone:302-898-5184
Practice Address - Fax:302-257-5621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty