NPIMap

Individual provider Active NPI

Diana Benjamin Rodriguez, LCSW CADC

  • Clinical Social Worker
  • Duluth, GA
National Provider Identifier
1184760738
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2400 Issued in GA
Practice address
6340 Sugarloaf Parkway
Suite 200
Duluth, GA 30097
Phone
(678) 775-6750
Fax
(678) 623-3396
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C0019 GA
Addiction (Substance Use Disorder) Counselor 101YA0400X ICAADC1308 GA
Clinical Social Worker 1041C0700X 2400 GA Primary

Addresses

Primary practice location

6340 Sugarloaf Parkway
Suite 200
Duluth, GA 30097

Mailing address

6340 Sugarloaf Parkway
Suite 200
Duluth, GA 30097
Phone (678) 775-6750

Other names 1

  • Mrs. Diana Benjamin Rodriguez Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0019GAMDAddiction (Substance Use Disorder) Counselor
ICAADC1308GAMDAddiction (Substance Use Disorder) Counselor
2400GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jose L. Cangiano,M.D.,P.C. Past Accepting new patients
Bremus Counseling Services LLC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1184760738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 SUGARLOAF PARKWAY",
            "address_2": "SUITE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "678-775-6750",
            "fax_number": "678-623-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SUGARLOAF PARKWAY",
            "address_2": "SUITE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "678-775-6750",
            "fax_number": "678-623-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DIANA",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW  CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "C0019",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "ICAADC1308",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "2400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BENJAMIN RODRIGUEZ",
            "prefix": "MRS.",
            "credential": "LSCW CADC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.