Provider Demographics
NPI:1891564647
Name:RODRIGUEZ-JOSEPHS, BERNADETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:RODRIGUEZ-JOSEPHS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5711 DRYSTONE LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5313
Mailing Address - Country:US
Mailing Address - Phone:718-730-5352
Mailing Address - Fax:
Practice Address - Street 1:5711 DRYSTONE LN
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5313
Practice Address - Country:US
Practice Address - Phone:718-730-5352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107956101Y00000X
NY72-091192101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor