Provider Demographics
NPI:1467790592
Name:RODRIGUEZ-FISCHER, MARIA DEJESUS (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEJESUS
Last Name:RODRIGUEZ-FISCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NEW PATHWAYS
Other - Middle Name:
Other - Last Name:COUNSELING AND COACHING PLLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21 W COLONY PL STE 250
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5589
Mailing Address - Country:US
Mailing Address - Phone:919-401-8261
Mailing Address - Fax:919-401-8261
Practice Address - Street 1:21 W COLONY PL SUITE 250
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705
Practice Address - Country:US
Practice Address - Phone:919-401-8261
Practice Address - Fax:919-401-8261
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0077851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467790592Medicaid