Provider Demographics
NPI:1336736685
Name:DEBORAH RODRIGUEZ LPC LLC
Entity Type:Organization
Organization Name:DEBORAH RODRIGUEZ LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSEDPROFESSIONALCOUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC
Authorized Official - Phone:904-307-8843
Mailing Address - Street 1:4122 DUCKHORN DR
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-9474
Mailing Address - Country:US
Mailing Address - Phone:904-307-8843
Mailing Address - Fax:412-810-8386
Practice Address - Street 1:2009 MACKENZIE WAY STE 100
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-5338
Practice Address - Country:US
Practice Address - Phone:904-307-8843
Practice Address - Fax:412-810-8386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty