Organization
CERULEAN WILLOW MENTAL HEALTH COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAISY DENISE RODRIGUEZ LMHC (FOUNDER)
(631) 512-3079
Entity
Organization
Contact information
Practice address
1227 MAIN ST STE 302, PORT JEFFERSON, NY 11777-2227
(631) 512-3079
Mailing address
PO BOX 685, OYSTER BAY, NY 11771-0685
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
10/24/2023
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