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NPI 1235924192

NPI 1235924192 : CAROLINA RODRIGUEZ MSW, PEL, LSW : LAKE VILLA, IL

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General NPI Number Information
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    NPI Number           |    1235924192
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    Entity Type          |    Individual 
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    Provider Name        |    CAROLINA RODRIGUEZ MSW, PEL, LSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/11/2025
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    Last Update Date     |    04/11/2025
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Provider Practice Location Address
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    Address Line         |    126 OAKTON LN 
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    City                 |    LAKE VILLA
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    State                |    IL
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    Zip                  |    60046-6653
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    Country              |    US
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    Telephone            |    847-373-2796
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    126 OAKTON LN 
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    City                 |    LAKE VILLA
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    State                |    IL
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    Zip                  |    60046-6653
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    Country              |    US
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    Telephone            |    847-373-2796
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041S0200X
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    Taxonomy Name        |    School Social Worker
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    License Number       |    
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    License Number State |    IL
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