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General NPI Number Information
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NPI Number | 1275958753
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Entity Type | Individual
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Provider Name | FREDDIE VAZQUEZ-RODRIGUEZ CASAC-G, LCSW (RI)
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Gender | Male
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 19 UNION SQ W FLOOR 7
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City | NEW YORK
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State | NY
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Zip | 10003-3304
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Country | US
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Telephone | 212-627-9600
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Fax | 212-627-4040
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Provider Business Mailing Address
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Address Line | 9610 57TH AVE APT ROME2J
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City | CORONA
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State | NY
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Zip | 11368-3436
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Country | US
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Telephone | 917-804-6987
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Fax | 917-804-6987
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8673
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.112973
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW03457
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 19114
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License Number State | NY
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