Individual provider Active NPI

Cristina Rodriguez, MSW,BA,LMSW

  • Social Worker
  • Waterbury, CT
National Provider Identifier
1194193482
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
002046 Issued in CT
Practice address
141 E Main St
Home Based Services 3Rd Floor
Waterbury, CT 06702-2310
Phone
(203) 575-0466
Fax
(203) 575-1817
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 002046 CT Primary

Addresses

Primary practice location

141 E Main St
Home Based Services 3Rd Floor
Waterbury, CT 06702-2310

Mailing address

141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other identifiers 13

IdentifierTypeStateIssuer
060669107OtherCTUBH -CONNECTICARE WELLMORE GRP/FACILITY
060669107OtherCTUBH- UNITED HEALTHCARE WELLMORE GRP/FACILITY
D339209- 141 E MAINOtherCTVALUE OPTIONS
PENDINGOtherCTCIGNA BEHAVIORAL HEALTH
060669107OtherCTHEALTHYCT GRP/FACILITY
060669107OtherCTUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
060669107OtherCTANTHEM BCBS OF CT WELLMORE GRP/FACILITY
NOT ELIGIBLEOtherCTMHN MANAGED HEALTH NETWORK
PENDINGOtherCTAETNA BEHAVIORAL HEALTH
008062547MedicaidCT
13671480OtherCTCAQH
060669107OtherCTUBH-LIBERTY/OXFORD HEALTH PLANS WELLMORE GRP/FACILITY
NOT ELIGIBLEOtherCTMHN TRICARE NORTH

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 Arts

State licenses

LicenseStateTypeSpecialty
002046CTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1194193482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "HOME BASED SERVICES 3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-575-0466",
            "fax_number": "203-575-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CRISTINA",
        "credential": "MSW,BA,LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "002046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH -CONNECTICARE   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH- UNITED HEALTHCARE WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "D339209- 141 E MAIN",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT   GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH    WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN MANAGED HEALTH NETWORK",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008062547",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13671480",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-LIBERTY/OXFORD HEALTH PLANS WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN TRICARE NORTH",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.