Provider Demographics
NPI:1962519629
Name:RODRIGUEZ, ADA G (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:ADA
Middle Name:G
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
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Mailing Address - Street 1:100 MARKET SQ STE 14
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2921
Mailing Address - Country:US
Mailing Address - Phone:860-665-9733
Mailing Address - Fax:860-541-5352
Practice Address - Street 1:100 MARKET SQ STE 14
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2921
Practice Address - Country:US
Practice Address - Phone:860-665-9733
Practice Address - Fax:860-541-5352
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional