Provider Demographics
NPI:1588340681
Name:RODRIGUEZ, AMBER NICOLE (SWC, RCSWI, MSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:SWC, RCSWI, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8125 W FLOYD AVE APT 11-201
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-4746
Mailing Address - Country:US
Mailing Address - Phone:720-938-2933
Mailing Address - Fax:
Practice Address - Street 1:8125 W FLOYD AVE APT 11-201
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-4746
Practice Address - Country:US
Practice Address - Phone:720-938-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW185701041C0700X
COSWC.00000016841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical