Provider Demographics
NPI:1558763813
Name:RODRIGUEZ, SHELY ELIRNI
Entity Type:Individual
Prefix:MISS
First Name:SHELY
Middle Name:ELIRNI
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-5055
Mailing Address - Country:US
Mailing Address - Phone:978-473-0465
Mailing Address - Fax:
Practice Address - Street 1:94 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-5055
Practice Address - Country:US
Practice Address - Phone:978-473-0465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily