Provider Demographics
NPI:1134543184
Name:RODRIGUEZ, REBECCA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:FAS PSYCH, LCC
Mailing Address - Street 2:8687 E. VIA DE VENTURA, #310
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:508-559-1567
Mailing Address - Fax:
Practice Address - Street 1:FAS PSYCH, LCC
Practice Address - Street 2:8687 E. VIA DE VENTURA, #310
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:508-559-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1220491041C0700X
NY2193121041C0700X
MA2193121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical