MRS. JACQUELINE RODRIGUEZ (NPI# 1003288168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003288168 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELINE RODRIGUEZ |
| Credential | LADC,CAC,APP |
| Practice Address |
243 Success Ave Bridgeport CT 06610-2429 |
| Practice Telephone | 2038648429 |
| Mailing Telephone | 2038648429 |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2016-10-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
001104 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | AETNA BEHAVIORAL HEALTH | PENDING | 01 |
| CT | UNITED BEHAVIORAL HEALTH- OPTUM WELLMORE GRP/FACILITY | 060669107 | 01 |
| CT | MHN TRICARE NORTH | PENDING | 01 |
| CT | ANTHEM BCBS OF CT WELLMORE GRP/FACILITY | 060669107 | 01 |
| CT | UBH- CONNECTICARE WELLMORE GRP/FACILITY | 060669107 | 01 |
| CT | ICADC INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR CCB | ICADC-5511 | 01 |
| CT | MHN MANAGED HEALTH NETWORK | PENDING | 01 |
| CT | PENDING | 05 | |
| CT | CAC- CERTIFIED ADDICTION COUNSELOR CCB | CAC-5511 | 01 |
| CT | UBH-OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY | 060669107 | 01 |
| CT | UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY | 060669107 | 01 |
| CT | CAQH | PENDING | 01 |
| CT | CIGNA BEHAVIORAL HEALTH | PENDING | 01 |
| CT | HEALTHYCT WELLMORE GRP/FACILITY | 060669107 | 01 |
| CT | APP ASSOCIATE PREVENTION PROFESSIONAL CCB | APP-5511 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477187912 | Jacqueline Rodriguez | Technician/Technologist | 1110 Vuelta De Las Acequias, Santa Fe, NM 87507-7105 | 2020-02-24 |
| 1316590102 | Jacqueline Rodriguez | Licensed Practical Nurse | 972 Florence Ave, Schenectady, NY 12303-1506 | 2019-07-20 |
| 1467922161 | Jacqueline Rodriguez | Dietitian, Registered | 4615 Nw 77th Ave, Miami, FL 33166-6449 | 2018-11-26 |
| 1922532183 | Jacqueline Rodriguez | Physical Therapist | 401 N Canal St, Carlsbad, NM 88220-5873 | 2017-04-14 |
| 1962725325 | Jacqueline Rodriguez | Social Worker | 17440 Blythe St, Northridge, CA 91325-4420 | 2010-03-12 |
| 1598831505 | Jacqueline Rodriguez | Nurse Practitioner | 3357 E Gage Ave, Huntington Park, CA 90255-5530 | 2006-11-28 |
| 1750477691 | Jacqueline Rodriguez | Dentist | Street 156 Km 49 4 Bo Sumidero, Aguas Buenas, PR 00703 | 2006-10-05 |
| 1790386639 | Jacqueline Rodriguez | Family Medicine | 8400 Nw 33rd St Ste 201, Doral, FL 33122-1937 | 2020-11-06 |
| 1154949717 | Jacqueline Guadalupe Rodriguez | Specialist/Technologist | 2095 Hillside Rd # U-1110, Storrs, CT 06269-1110 | 2020-07-10 |
| 1649890914 | Jacqueline Anne Rodriguez | Student in an Organized Health Care Education/Training Program | 121 Dekalb Ave, Brooklyn, NY 11201-5425 | 2020-04-16 |
| Street Address |
243 SUCCESS AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553698 | Juan G Farfan | Nurse Anesthetist, Certified Registered | 267 Grant Sreet, Bridgeport, CT 06610 | 2020-06-22 |
| 1104446145 | Deepak Rajkumar Vangipuram | Student in an Organized Health Care Education/Training Program | Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-20 |
| 1275152886 | Soniya Abraham | Student in an Organized Health Care Education/Training Program | Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-14 |
| 1538621834 | Yu Mi Kang | Student in an Organized Health Care Education/Training Program | 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 | 2019-04-04 |
| 1073075024 | Ashwin Pramod Deshmukh | Student in an Organized Health Care Education/Training Program | Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2019-04-01 |
| 1790246866 | Prachi Mangesh Pednekar | Student in an Organized Health Care Education/Training Program | Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 | 2019-03-29 |
| 1194247916 | Jessica M. Maddern | Social Worker | 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 | 2017-07-13 |
| 1922532746 | Megha Kureti | Student in an Organized Health Care Education/Training Program | 267 Grant St Fl 3, Bridgeport, CT 06610 | 2017-04-18 |
| 1831623099 | Cynthia Joseph Walters | Nurse Anesthetist, Certified Registered | Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 | 2017-04-14 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952912271 | Patience Ashong | Counselor | 191 High Ridge Dr, Bridgeport, CT 06606-4965 | 2020-08-11 |
| 1871133371 | Pamela Mcmahon | Counselor | 3851 Main St Fl 2, Bridgeport, CT 06606-2864 | 2020-01-13 |
| 1922580737 | Jacqueline Renee Scott | Counselor | 566 Wilmot Ave Unit 1, Bridgeport, CT 06607-1107 | 2018-08-29 |
| 1225556418 | Louis L Reed | Counselor | 3334 Main St, Bridgeport, CT 06606-4227 | 2017-09-07 |
| 1609396951 | Eleanora Morgan | Counselor | 336 Midland St, Bridgeport, CT 06605-3546 | 2017-06-27 |
| 1316487630 | Louis L. Reed | Counselor | 189 Smith St, Bridgeport, CT 06607-2220 | 2017-03-06 |
| 1487024238 | Onorio Dadamo | Counselor | 350 Fairfield Ave, Bridgeport, CT 06604-6014 | 2015-10-05 |
| 1588985584 | Fritz Maignan | Counselor | 48 Alpine St, Bridgeport, CT 06610-1727 | 2010-06-14 |
| 1942453287 | Darrin Allan Mcallister | Counselor | 289 Laurel Ave, Bridgeport, CT 06605-1102 | 2008-10-30 |
| 1861663619 | Michael Glendon | Counselor | 1046 Fairfield Avenue, Bridgeport, CT 06605-1116 | 2008-03-20 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
Please comment or provide details below to improve the information on MRS. JACQUELINE RODRIGUEZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.