Provider Demographics
NPI:1447402011
Name:RODRIGUEZ, CYNTHIA CORRETJER (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:CORRETJER
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CARLISLE WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-2101
Mailing Address - Country:US
Mailing Address - Phone:845-326-1747
Mailing Address - Fax:
Practice Address - Street 1:30 CARLISLE WAY
Practice Address - Street 2:
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-2101
Practice Address - Country:US
Practice Address - Phone:845-326-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0465641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical