Individual provider Active NPI

Jennifer Brier Rodriquez, BS, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Wilmington, NC
National Provider Identifier
1063537447
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1973 Issued in NC
Practice address
1606 Physicians Dr
Suite 104
Wilmington, NC 28401-7361
Phone
(910) 362-8881
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1973 NC Primary

Addresses

Primary practice location

1606 Physicians Dr
Suite 104
Wilmington, NC 28401-7361

Mailing address

154 N Belvedere Dr
Hampstead, NC 28443-2426
Phone (910) 270-5329

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
1973NCMDSchool Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063537447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 N BELVEDERE DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284432426",
            "telephone_number": "910-270-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 PHYSICIANS DR",
            "address_2": "SUITE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017361",
            "telephone_number": "910-362-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIQUEZ",
        "first_name": "JENNIFER",
        "middle_name": "BRIER",
        "credential": "BS, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.