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Organization
MYCHATTHERAPIST LCSW PLLC
Active
Organization
MYCHATTHERAPIST LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ENRIQUE RODRIGUEZ LCSW (CLINICAL THERAPIST)
(718) 926-3170
Entity
Organization
Contact information
Practice address
666 ONDERDONK AVE, RIDGEWOOD, NY 11385-2207
(718) 926-3170
Mailing address
666 ONDERDONK AVE, #1, RIDGEWOOD, NY 11385-2207
(718) 926-3170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R055338
NY
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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