Healthcare Provider Details

I. General information

NPI: 1922756931
Provider Name (Legal Business Name): AIMEE RODRIGUEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 WHEATFIELD WAY
SALINE MI
48176-1818
US

IV. Provider business mailing address

1940 S WESTERN AVE STE 205
CHICAGO IL
60608-2503
US

V. Phone/Fax

Practice location:
  • Phone: 313-408-8483
  • Fax:
Mailing address:
  • Phone: 708-515-7973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801120448
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801120448
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149028801
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: