Provider Demographics
NPI:1366640419
Name:RODRIGUEZ, BEATRIZ A (LCSW)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:A
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 1:7040 LAREDO ST STE K
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3044
Mailing Address - Country:US
Mailing Address - Phone:707-331-4874
Mailing Address - Fax:702-446-8034
Practice Address - Street 1:7040 LAREDO ST STE K
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3044
Practice Address - Country:US
Practice Address - Phone:707-331-4874
Practice Address - Fax:707-446-8034
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAACSW 24891101YM0800X
CALCSW 596051041C0700X
NV6747-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health