Individual provider Active NPI

Rebecca Rodriguez, LCSW

  • Clinical Social Worker
  • Scottsdale, AZ
National Provider Identifier
1134543184
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
219312 Issued in MA
Practice address
Fas Psych, LCC
8687 E. Via de Ventura, #310
Scottsdale, AZ 85258
Phone
(508) 559-1567
NPI assigned
Feb 11, 2014
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 122049 MA
Clinical Social Worker 1041C0700X 219312 NY
Clinical Social Worker 1041C0700X 219312 MA Primary

Addresses

Primary practice location

Fas Psych, LCC
8687 E. Via de Ventura, #310
Scottsdale, AZ 85258

Mailing address

Fas Psych, LCC
8687 E. Via de Ventura, #310
Scottsdale, AZ 85258
Phone (508) 559-1567

Other names 1

  • Rebecca Vega Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821001211 MA Practitioner - Clinical Social Worker 7618195322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122049MAMDClinical Social Worker
219312MAMDClinical Social Worker
219312NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Oct 7, 2021 Accepting new patients

Locations

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone (617) 395-5806

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1134543184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FAS PSYCH, LCC",
            "address_2": "8687 E. VIA DE VENTURA, #310",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85258",
            "telephone_number": "508-559-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAS PSYCH, LCC",
            "address_2": "8687 E. VIA DE VENTURA, #310",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85258",
            "telephone_number": "508-559-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "REBECCA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122049",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "219312",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "219312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "VEGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.