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General NPI Number Information
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NPI Number | 1477323400
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Entity Type | Organization
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Legal Business Name | LESLIE RODRIGUEZ, LPC,LLC
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Dates
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Enumeration Date | 01/02/2024
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 100 E HANOVER AVE STE 203
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2047
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Country | US
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Telephone | 908-752-9034
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Fax | 973-695-1823
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Provider Business Mailing Address
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Address Line | 100 E HANOVER AVE STE 203
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2047
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Country | US
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Telephone | 908-752-9034
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Fax | 973-695-1823
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Authorized Official
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Title or Position | COUNSELOR
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Name | LESLIE RODRIGUEZ
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Credential | LPC
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Telephone | 908-752-9034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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