Provider Demographics
NPI:1215459805
Name:RODRIGUEZ, URIEL SR (LCSW)
Entity type:Individual
Prefix:
First Name:URIEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VISTAS DE COAMO
Mailing Address - Street 2:484 LAS CASCADAS
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-341-0447
Mailing Address - Fax:
Practice Address - Street 1:URB LA VEGA C60
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766
Practice Address - Country:US
Practice Address - Phone:787-341-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR109791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical