Michael Jordy Rodriguez, LCSW
Social Worker, Clinical in Fresh Meadows, NY. Individual provider (NPI-1).
NPI number1013466366
StatusActive
Last updated in NPPESJun 19, 2018
Details
- NPI
- 1013466366
- Entity type
- Individual (NPI-1)
- Name
- Mr. Michael Jordy Rodriguez
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2016
- Last updated
- Jun 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 086539 | NY | Yes |
| 104100000X | Social Worker | 090124 | NY |
Practice location
4828 196th PlFresh Meadows, NY 11365
Phone 917-224-1245
Mailing address
4828 196th PlFresh Meadows, NY 11365-1321
Phone 917-224-1245
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