Provider Demographics
NPI:1114343407
Name:RODRIGUEZ, JOANNA (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-4910
Mailing Address - Country:US
Mailing Address - Phone:201-428-1775
Mailing Address - Fax:
Practice Address - Street 1:1182 TEANECK RD STE 206
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4838
Practice Address - Country:US
Practice Address - Phone:201-357-2715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05938300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker