Provider Demographics
NPI:1134099211
Name:RODRIGUEZ, REBECCA WINTER (LCSW)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:WINTER
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 BROADHOLLOW RD STE 120
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4863
Mailing Address - Country:US
Mailing Address - Phone:631-323-6872
Mailing Address - Fax:631-918-5768
Practice Address - Street 1:275 BROADHOLLOW RD STE 120
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4863
Practice Address - Country:US
Practice Address - Phone:631-323-6872
Practice Address - Fax:631-918-5768
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0737941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical