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General NPI Number Information
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NPI Number | 1659837474
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Entity Type | Individual
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Provider Name | ORLANDO RODRIGUEZ LAC, LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/17/2019
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 200 S SHERIDAN BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80226-8005
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Country | US
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Telephone | 720-496-4170
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Fax |
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Provider Business Mailing Address
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Address Line | 1226 E RUSTIC DR
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City | PUEBLO WEST
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State | CO
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Zip | 81007-6519
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Country | US
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Telephone | 719-334-4521
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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 | CSW.09929667
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0002322
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License Number State | CO
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