Provider Demographics
NPI:1801102249
Name:RODRIGUEZ, LAURA E (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5226 RAINS
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-9336
Mailing Address - Country:US
Mailing Address - Phone:956-206-2853
Mailing Address - Fax:
Practice Address - Street 1:10101 S 1ST ST
Practice Address - Street 2:APT 717
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6675
Practice Address - Country:US
Practice Address - Phone:956-206-2853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11091101YA0400X
TX63692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)