Healthcare Provider Details

I. General information

NPI: 1922660208
Provider Name (Legal Business Name): FLORDALIZA RODRIGUEZ MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 GARSIDE ST
NEWARK NJ
07104-1911
US

IV. Provider business mailing address

163 GARSIDE ST
NEWARK NJ
07104-1911
US

V. Phone/Fax

Practice location:
  • Phone: 973-902-5372
  • Fax:
Mailing address:
  • Phone: 973-902-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1109995
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37PC0253900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: