Provider Demographics
NPI:1215997986
Name:RODRIGUEZ, YVETTE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 57TH DR
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1903
Mailing Address - Country:US
Mailing Address - Phone:718-446-7409
Mailing Address - Fax:718-606-9384
Practice Address - Street 1:7031 57TH DR
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1903
Practice Address - Country:US
Practice Address - Phone:718-446-7409
Practice Address - Fax:718-606-9384
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0719771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical