Individual
MS. SUHAIL DARIE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, LADC
Contact information
Practice address
357 WHITNEY AVENUE, G-05 REAR, NEW HAVEN, CT 06511
(203) 779-6811
Mailing address
140 COLONY ST, HAMDEN, CT 06518-3324
(203) 935-7164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000815
CT
101YM0800X
Mental Health Counselor
Primary
003267
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008077718
—
CT
Enumeration date
06/03/2011
Last updated
04/02/2018
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