Provider Demographics
NPI:1225921455
Name:RODRIGUEZ, DEANNIE MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:DEANNIE
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DEANNIE
Other - Middle Name:MARIE
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:19114 MERCANT MARK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3478
Mailing Address - Country:US
Mailing Address - Phone:973-572-8103
Mailing Address - Fax:
Practice Address - Street 1:19114 MERCANT MARK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3478
Practice Address - Country:US
Practice Address - Phone:973-572-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty