Provider Demographics
NPI:1568050755
Name:RODRIGUEZ, ANA R (LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:R
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 1:1109 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-3723
Mailing Address - Country:US
Mailing Address - Phone:609-334-1748
Mailing Address - Fax:
Practice Address - Street 1:505 NEW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1609
Practice Address - Country:US
Practice Address - Phone:609-892-3758
Practice Address - Fax:609-840-6213
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059625001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical