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General NPI Number Information
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NPI Number | 1568935294
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Entity Type | Individual
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Provider Name | CHRISTIAN ALCIDE RODRIGUEZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 148 W 125TH ST FRNT 2
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City | NEW YORK
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State | NY
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Zip | 10027-4589
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Country | US
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Telephone | 212-609-7285
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Fax |
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Provider Business Mailing Address
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Address Line | 420 W 42ND ST APT 8C
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City | NEW YORK
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State | NY
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Zip | 10036-6838
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Country | US
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Telephone | 917-449-1735
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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 | 094798
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License Number State | NY
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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 | 104737-1
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License Number State | NY
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