MEDICARE: ASHLEY NICHOLE RODRIGUEZ LMSW

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	6801119957	MI

General Provider Information

NPI Number	:	1700439502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NICHOLE RODRIGUEZ LMSW

Provider Business Mailing Address
First Line	:	950 W NORTON AVE STE 301
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-4183
Country	:	US
Telephone Number	:	616-942-7294
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 W NORTON AVE STE 301
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-4183
Country	:	US
Telephone Number	:	616-942-7294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2019
Last Update Date	:	05/10/2026

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