Provider Demographics
NPI:1255524153
Name:RODRIGUEZ, ADRIAN RAMON (MSW- LMSW- LCSW)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:RAMON
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MSW- LMSW- LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 451485
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77245-1485
Mailing Address - Country:US
Mailing Address - Phone:713-270-0764
Mailing Address - Fax:713-270-7999
Practice Address - Street 1:6607 MISTFLOWER LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7250
Practice Address - Country:US
Practice Address - Phone:713-270-0764
Practice Address - Fax:713-270-7999
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5047101YM0800X
TX27407 LMSW-IPR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health