Provider Demographics
NPI:1609377449
Name:RODRIGUEZ, ALECIA (PHD, LMFT, MFT, CSOT)
Entity Type:Individual
Prefix:DR
First Name:ALECIA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD, LMFT, MFT, CSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10360 SW 186TH ST UNIT 970831
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33197-5038
Mailing Address - Country:US
Mailing Address - Phone:888-241-8802
Mailing Address - Fax:305-703-0594
Practice Address - Street 1:10360 SW 186TH ST UNIT 970831
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33197-5038
Practice Address - Country:US
Practice Address - Phone:305-491-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COMFT.0002442106H00000X, 106H00000X
VA0717002039106H00000X
FL106S00000X, 103TF0000X, 106H00000X, 106S00000X, 261QM0801X
FLMT4717106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0Medicaid