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General NPI Number Information
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NPI Number | 1386250579
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Entity Type | Individual
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Provider Name | JODI MANCINI RODRIGUEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 6212 W CORPORATE OAKS DR
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-2694
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Country | US
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Telephone | 352-423-0542
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 341
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City | HOLDER
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State | FL
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Zip | 34445-0341
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Country | US
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Telephone | 352-423-0542
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW16044
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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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 | SW21726
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License Number State | FL
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