Provider Demographics
NPI:1457087793
Name:RODRIGUEZ, SARA MARIEE (CSW-I)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIEE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 BLUSHING ROSE PL
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-8628
Mailing Address - Country:US
Mailing Address - Phone:702-624-0253
Mailing Address - Fax:
Practice Address - Street 1:9748 GILESPIE ST STE 350
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7618
Practice Address - Country:US
Practice Address - Phone:702-624-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06799-I101YA0400X
NV9164-M101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)