Provider Demographics
NPI:1659986297
Name:THERESA RODRIGUEZ COUNSELING LLC
Entity Type:Organization
Organization Name:THERESA RODRIGUEZ COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:352-359-0264
Mailing Address - Street 1:1810 NW 6TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-8535
Mailing Address - Country:US
Mailing Address - Phone:352-359-0264
Mailing Address - Fax:
Practice Address - Street 1:1810 NW 6TH ST STE C
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8535
Practice Address - Country:US
Practice Address - Phone:352-359-0264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty