Provider Demographics
NPI:1851096747
Name:RODRIGUEZ, ADRIAN (LCSW CCM)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:LCSW CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 REMCON CIR UNIT 622
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7362 REMCON CIR UNIT 622
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1623
Practice Address - Country:US
Practice Address - Phone:915-294-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical