MEDICARE: ERICA LYNN RODRIGUEZ MFT

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1861819724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LYNN RODRIGUEZ MFT

Provider Business Mailing Address
First Line	:	2 WATERSIDE XING STE 401
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-1588
Country	:	US
Telephone Number	:	860-731-5522
Fax Number	:	860-731-5536

Provider Business Practice Location Address
First Line	:	999 ASYLUM AVE STE 502
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06105-2475
Country	:	US
Telephone Number	:	860-422-8384
Fax Number	:

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

Provider Enumeration Date	:	03/27/2014
Last Update Date	:	07/21/2020

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