Provider Demographics
NPI:1831554112
Name:RODRIGUEZ, CATHLEEN E (LPC)
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:E
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CATHLEEN
Other - Middle Name:E
Other - Last Name:HARBOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65402-0863
Mailing Address - Country:US
Mailing Address - Phone:208-718-8276
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 863
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65402-0863
Practice Address - Country:US
Practice Address - Phone:208-718-8276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ID5955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health