Provider Demographics
NPI:1366510273
Name:RODRIGUEZ-ARSENEAU, MARITZA (LPC)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:RODRIGUEZ-ARSENEAU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARITZA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:3560 PINE GROVE AVE
Mailing Address - Street 2:216
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-1994
Mailing Address - Country:US
Mailing Address - Phone:810-407-2075
Mailing Address - Fax:
Practice Address - Street 1:3560 PINE GROVE AVE
Practice Address - Street 2:216
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-1994
Practice Address - Country:US
Practice Address - Phone:810-407-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4598101YM0800X
MI01010995101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health