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NPI Code Detail

MEDICARE: MS. DANIELLE JASMINE RODRIGUEZ LCPC

MEDICARE: MS. DANIELLE JASMINE RODRIGUEZ LCPC
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 Counselor180017122IL

General Provider Information

NPI Number : 1740167659
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DANIELLE JASMINE RODRIGUEZ LCPC
Provider Business Mailing Address
First Line : 2600 RIDGELAND AVE
Second Line :
City : BERWYN
State : IL
Zip : 60402-2725
Country : US
Telephone Number : 708-317-5926
Fax Number :
Provider Business Practice Location Address
First Line : 2600 RIDGELAND AVE
Second Line :
City : BERWYN
State : IL
Zip : 60402-2725
Country : US
Telephone Number : 708-317-5926
Fax Number : 708-637-4316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2025
Last Update Date : 01/31/2026

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