Active NPI
Jahaira Rodriguez, LCSW
- Clinical Social Worker
- Atlanta, GA
National Provider Identifier
1114215837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW004457
- Practice address
- 1364 Clifton Rd NE
Atlanta, GA 30322-1059 - Phone
- (352) 286-4129
- NPI assigned
- Jul 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW004457 | GA | Primary |
| Clinical Social Worker | 1041C0700X | SW 10255 | FL |
Addresses
Primary practice location
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Mailing address
PO Box 197
Avondale Estates, GA 30002-0197
Phone (352) 286-4129
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 10255 | FL | MD | Clinical Social Worker |
| CSW004457 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310601600000",
"number": "1114215837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 197",
"city": "AVONDALE ESTATES",
"state": "GA",
"postal_code": "300020197",
"telephone_number": "352-286-4129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1364 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221059",
"telephone_number": "352-286-4129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JAHAIRA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-14",
"last_updated": "2011-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW004457",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 10255",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.