Provider Demographics
NPI:1285835462
Name:RODRIGUEZ, ZULMA ROSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ZULMA
Middle Name:ROSA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 BROADWAY APT 17161
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2152
Mailing Address - Country:US
Mailing Address - Phone:646-678-0687
Mailing Address - Fax:
Practice Address - Street 1:2109 BROADWAY APT 17161
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2152
Practice Address - Country:US
Practice Address - Phone:646-678-0687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068546104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker