Healthcare Provider Details

I. General information

NPI: 1215459805
Provider Name (Legal Business Name): URIEL RODRIGUEZ SR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 778 KM 0.9 BO. PASARELL
COMERIO PR
00782
US

IV. Provider business mailing address

URB VISTAS DE COAMO 484 LAS CASCADAS
COAMO PR
00769
US

V. Phone/Fax

Practice location:
  • Phone: 787-875-0943
  • Fax:
Mailing address:
  • Phone: 787-341-0447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10979
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: