MRS. JACQUELINE RODRIGUEZ LADCCACAPP NPI 1003288168

NPI Information

NPI: 1003288168
Provider Name: MRS. JACQUELINE RODRIGUEZ, LADC,CAC,APP
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
243 SUCCESS AVE
BRIDGEPORT, CT
ZIP 06610
Phone: (203) 864-8429
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MRS. Jacqueline Rodriguez, LADC,CAC,APP is an addiction (substance use disorder) counselor in Bridgeport, CT. MRS. Jacqueline Rodriguez, LADC,CAC,APP NPI is 1003288168. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

243 SUCCESS AVE
BRIDGEPORT, CT
ZIP 06610-429
Phone: (203) 864-8429

The enumeration date for this NPI number is 10/28/2015 and was last updated on 10/31/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	001104	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	060669107	OTHER	CONNECTICUT	HEALTHYCT WELLMORE GRP/FACILITY
2	PENDING	OTHER	CONNECTICUT	CAQH
3	PENDING	OTHER	CONNECTICUT	MHN MANAGED HEALTH NETWORK
4	060669107	OTHER	CONNECTICUT	UNITED BEHAVIORAL HEALTH- OPTUM WELLMORE GRP/FACILITY
5	060669107	OTHER	CONNECTICUT	UBH- CONNECTICARE WELLMORE GRP/FACILITY
6	ICADC-5511	OTHER	CONNECTICUT	ICADC INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR CCB
7	060669107	OTHER	CONNECTICUT	UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
8	PENDING	OTHER	CONNECTICUT	AETNA BEHAVIORAL HEALTH
9	060669107	OTHER	CONNECTICUT	UBH-OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY
10	NOT ELIGIBLE	MEDICARE UPIN	CONNECTICUT
11	CAC-5511	OTHER	CONNECTICUT	CAC- CERTIFIED ADDICTION COUNSELOR CCB
12	PENDING	OTHER	CONNECTICUT	MHN TRICARE NORTH
13	APP-5511	OTHER	CONNECTICUT	APP ASSOCIATE PREVENTION PROFESSIONAL CCB
14	PENDING	OTHER	CONNECTICUT	CIGNA BEHAVIORAL HEALTH
15	PENDING	MEDICAID	CONNECTICUT
16	060669107	OTHER	CONNECTICUT	ANTHEM BCBS OF CT WELLMORE GRP/FACILITY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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