Provider Demographics
NPI:1245416676
Name:RODRIGUEZ, HAYDEE (MS LMHC CAP)
Entity Type:Individual
Prefix:
First Name:HAYDEE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS LMHC CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3034
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32721-3034
Mailing Address - Country:US
Mailing Address - Phone:386-738-7594
Mailing Address - Fax:
Practice Address - Street 1:3034
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3034
Practice Address - Country:US
Practice Address - Phone:386-738-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP101YA0400X
FL4937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)