Individual
CRISTINA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,BA,LMSW
Contact information
Practice address
141 E MAIN ST, HOME BASED SERVICES 3RD FLOOR, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 575-1817
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
002046
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008062547
—
CT
01
—
060669107
UBH -CONNECTICARE WELLMORE GRP/FACILITY
CT
01
—
13671480
CAQH
CT
01
—
D339209- 141 E MAIN
VALUE OPTIONS
CT
01
—
NOT ELIGIBLE
MHN MANAGED HEALTH NETWORK
CT
01
—
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
09/03/2015
Last updated
08/29/2016
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