Provider Demographics
NPI:1275052409
Name:RODRIGUEZ, ELIZABETH CARMEN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CARMEN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CONDON DR
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2636
Mailing Address - Country:US
Mailing Address - Phone:203-673-6148
Mailing Address - Fax:
Practice Address - Street 1:27 CONDON DR
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2636
Practice Address - Country:US
Practice Address - Phone:203-673-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0084931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical