Provider Demographics
NPI:1619956208
Name:RODRIGUEZ & ASSOCIATES, LTD
Entity Type:Organization
Organization Name:RODRIGUEZ & ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:563-355-4410
Mailing Address - Street 1:2213 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2785
Mailing Address - Country:US
Mailing Address - Phone:563-355-4410
Mailing Address - Fax:563-355-4110
Practice Address - Street 1:2213 E 52ND ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2785
Practice Address - Country:US
Practice Address - Phone:563-355-4410
Practice Address - Fax:563-355-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06287101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I13223Medicare UPIN