Provider Demographics
NPI:1811703804
Name:RODRIGUEZ, ALEXANDER IVAN (MSW, LSW)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:IVAN
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3305
Mailing Address - Country:US
Mailing Address - Phone:862-237-6611
Mailing Address - Fax:
Practice Address - Street 1:99 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1122
Practice Address - Country:US
Practice Address - Phone:973-794-6401
Practice Address - Fax:973-794-6405
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06781000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker