=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508633546
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REFUGIA BETH RODRIGUEZ LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2023
-----------------------------------------------------
Last Update Date | 01/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10824 E CRYSTAL FALLS PKWY STE 401
-----------------------------------------------------
City | LEANDER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78641-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-790-0307
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10824 E CRYSTAL FALLS PKWY STE 401
-----------------------------------------------------
City | LEANDER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78641-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-790-0307
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 67529
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------