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NPI Code Detail

MEDICARE: JAMIE SUSAN ROSALVA RODRIGUEZ LMHC-A

MEDICARE: JAMIE SUSAN ROSALVA RODRIGUEZ LMHC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor88002276AIN

General Provider Information

NPI Number : 1053206078
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE SUSAN ROSALVA RODRIGUEZ LMHC-A
Provider Business Mailing Address
First Line : 1234 N COURTLAND AVE
Second Line :
City : KOKOMO
State : IN
Zip : 46901-2754
Country : US
Telephone Number : 765-860-8365
Fax Number :
Provider Business Practice Location Address
First Line : 1234 N COURTLAND AVE
Second Line :
City : KOKOMO
State : IN
Zip : 46901-2754
Country : US
Telephone Number : 765-860-8365
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2025
Last Update Date : 06/10/2025

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Directions to “ JAMIE SUSAN ROSALVA RODRIGUEZ LMHC-A” Practice Location

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