MEDICARE: LUZ ALEXA RODRIGUEZ M.S.W., LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	IC-642	NV
2	1041C0700X	Clinical Social Worker	6441-C	NV

General Provider Information

NPI Number	:	1780998492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ ALEXA RODRIGUEZ M.S.W., LCSW

Provider Business Mailing Address
First Line	:	8685 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2839
Country	:	US
Telephone Number	:	702-754-0870
Fax Number	:

Provider Business Practice Location Address
First Line	:	8685 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2839
Country	:	US
Telephone Number	:	702-754-0870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	02/19/2019

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