Provider Demographics
NPI:1942784434
Name:RODRIGUEZ, SYLVETTE MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:SYLVETTE
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:CALLE 15 BUZON 105
Mailing Address - Street 2:BARRIO CARMELITA
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-566-2855
Mailing Address - Fax:
Practice Address - Street 1:CARR 149 KM 7.5
Practice Address - Street 2:BARRIO RIO ARRIBA SALIENTE
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-5700
Practice Address - Fax:787-884-5704
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR66631041C0700X
PR4117101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical