Active NPI
Elisa M Rodriguez, LADC
- Addiction (Substance Use Disorder) Counselor
- West Haven, CT
National Provider Identifier
1063245827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1578
- Practice address
- 184 Front Ave
West Haven, CT 06516-2836 - Phone
- (203) 781-4600
- Fax
- (203) 781-4624
- NPI assigned
- Aug 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1578 | CT | Primary |
Addresses
Primary practice location
184 Front Ave
West Haven, CT 06516-2836
Mailing address
1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946
Phone (203) 781-4600
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008068749 | Medicaid | CT | |
| 008068298 | Medicaid | CT | |
| 008068631 | Medicaid | CT | |
| 008129668 | Medicaid | CT | |
| 008068669 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1063245827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR STE 321",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115946",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 FRONT AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162836",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ELISA",
"middle_name": "M",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-26",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "1578",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008068749",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008068298",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008068631",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008129668",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008068669",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.