Provider Demographics
NPI:1932870516
Name:RODRIGUEZ, JESSICA MAE (MS LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MAE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 E FERNHURST DR STE 304
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1586
Mailing Address - Country:US
Mailing Address - Phone:346-361-0100
Mailing Address - Fax:
Practice Address - Street 1:8323 SOUTHWEST FWY STE 630
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1618
Practice Address - Country:US
Practice Address - Phone:832-831-6178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty