Provider Demographics
NPI:1497418727
Name:RODRIGUEZ, JEANNETTE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9115 FM 723 RD STE 550
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-9238
Mailing Address - Country:US
Mailing Address - Phone:832-417-6647
Mailing Address - Fax:832-415-0502
Practice Address - Street 1:1203 WINSTON HOMESTEAD CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2219
Practice Address - Country:US
Practice Address - Phone:832-417-6647
Practice Address - Fax:832-415-0502
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional