Healthcare Provider Details

I. General information

NPI: 1750242616
Provider Name (Legal Business Name): SONIA RODRIGUEZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 KINGSTON DR.
SINKING SPRING PA
19608
US

IV. Provider business mailing address

30 S 15TH ST STE 1550 PMB 784130
PHILADELPHIA PA
19102-4806
US

V. Phone/Fax

Practice location:
  • Phone: 484-509-1412
  • Fax:
Mailing address:
  • Phone: 484-509-1412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SONIA RODRIGUEZ
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 484-509-1412