Provider Demographics
NPI:1285913731
Name:RODRIGUEZ, DENISE J (LMHC)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:J
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 PLAINFIELD PIKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-5723
Mailing Address - Country:US
Mailing Address - Phone:401-368-1595
Mailing Address - Fax:
Practice Address - Street 1:2013 PLAINFIELD PIKE
Practice Address - Street 2:SUITE C
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-5723
Practice Address - Country:US
Practice Address - Phone:401-368-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00305101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor