Provider Demographics
NPI:1114265683
Name:RODRIGUEZ, PATRICIA (CADC-S, MSW INTERN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CADC-S, MSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 CORDONE AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2747
Mailing Address - Country:US
Mailing Address - Phone:775-354-4839
Mailing Address - Fax:
Practice Address - Street 1:205 S PRATT AVE
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-4730
Practice Address - Country:US
Practice Address - Phone:775-787-9411
Practice Address - Fax:775-787-9445
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1032101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)