Provider Demographics
NPI:1992560676
Name:RODRIGUEZ SMITH, NINA KATHLEEN (LMSW)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:KATHLEEN
Last Name:RODRIGUEZ SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 LOCH LOMOND CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2767
Mailing Address - Country:US
Mailing Address - Phone:817-319-2392
Mailing Address - Fax:
Practice Address - Street 1:130 HOPE ST APT 605
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-6081
Practice Address - Country:US
Practice Address - Phone:203-515-2087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120050104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker