Provider Demographics
NPI:1629757984
Name:RODRIGUEZ, ASHLEY JANELLE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JANELLE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4917
Mailing Address - Country:US
Mailing Address - Phone:202-384-3193
Mailing Address - Fax:
Practice Address - Street 1:1606 LIGHT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4917
Practice Address - Country:US
Practice Address - Phone:202-384-3193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker