=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841265352
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SONIA M RODRIGUES-MARTO MA, LPC, NCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3322 ROUTE 22 SUITE 424
-----------------------------------------------------
City | BRANCHBURG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08876-3476
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-221-0568
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1126 KERWIN ST
-----------------------------------------------------
City | PISCATAWAY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08854-3323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-968-1849
-----------------------------------------------------
Fax | 908-561-2649
-----------------------------------------------------
=====================================================
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 | 37PC00335800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------