Provider Demographics
NPI:1922503275
Name:RODRIGUES, ELIZABETH S (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 HOFFMANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MILLERS
Mailing Address - State:MD
Mailing Address - Zip Code:21102-2234
Mailing Address - Country:US
Mailing Address - Phone:301-639-2372
Mailing Address - Fax:
Practice Address - Street 1:222 BOSLEY AVE STE C6
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4399
Practice Address - Country:US
Practice Address - Phone:301-639-2372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8785101YP2500X
MDLGP7322101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)