Individual provider Active NPI

Jesus Rodriguez Jr., LPC,LCDC,ICADC,SAP

  • Professional Counselor
  • Laredo, TX
National Provider Identifier
1114753936
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
91349 Issued in TX
Practice address
6510 Polaris Dr Suite 1
Laredo, TX 78041-2054
Phone
(956) 308-3419
NPI assigned
Sep 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 91349 TX Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16677 TX

Addresses

Primary practice location

6510 Polaris Dr Suite 1
Laredo, TX 78041-2054

Mailing address

6510 Polaris Dr Ste 2
Laredo, TX 78041-2054
Phone (956) 308-3419

Other practice location 1

1101 South Capital of Texas Highway
Building J suite 100
Austin, TX 78746
Phone (956) 308-3419

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

LicenseStateTypeSpecialty
91349TXMDProfessional Counselor
16677TXMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Enriched Roots PLLC Addiction (Substance Use Disorder) Current Accepting new patients

Locations

6510 Polaris Dr
Ste 1
Laredo, TX 78041
Phone (956) 431-0402

6510 Polaris Dr
Ste 2
Laredo, TX 78041
Phone (956) 284-0780

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1114753936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 POLARIS DR STE 2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412054",
            "telephone_number": "956-308-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 POLARIS DR SUITE 1",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412054",
            "telephone_number": "956-308-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 South Capital of Texas Highway",
            "address_2": "Building J suite 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78746",
            "country_code": "US",
            "telephone_number": "956-308-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JESUS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC,LCDC,ICADC,SAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "91349",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "16677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.