Provider Demographics
NPI:1740647569
Name:RODRIGUEZ, SERENA DION (LMHC)
Entity type:Individual
Prefix:MS
First Name:SERENA
Middle Name:DION
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SERENA
Other - Middle Name:DION
Other - Last Name:FORWARD-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:5608 17TH AVE NW # 1332
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5232
Mailing Address - Country:US
Mailing Address - Phone:253-342-1900
Mailing Address - Fax:
Practice Address - Street 1:1402 AUBURN WAY N
Practice Address - Street 2:#247
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002
Practice Address - Country:US
Practice Address - Phone:253-342-1900
Practice Address - Fax:253-254-1900
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60913081101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor