Healthcare Provider Details

I. General information

NPI: 1922921220
Provider Name (Legal Business Name): ALEK JOSE RODRIGUEZ MA LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 NJ-36 BLDG B
LONG BRANCH NJ
07764-0730
US

IV. Provider business mailing address

1309 7TH AVE
NEPTUNE NJ
07753-5147
US

V. Phone/Fax

Practice location:
  • Phone: 732-858-5432
  • Fax:
Mailing address:
  • Phone: 732-996-7869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00948600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: