Active NPI
Lilliam Elisa Rodriguez, LCSW
- Clinical Social Worker
- Fort Campbell, KY
National Provider Identifier
1205151016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5458
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223 - Phone
- (270) 956-4618
- Fax
- (270) 412-6889
- NPI assigned
- Apr 5, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5458 | TN | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223
Mailing address
650 Joel Avenue
Blanchfield Army Community Hospital
Ft. Campbell, KY 42223
Phone (270) 956-4618
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1205151016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 JOEL AVENUE",
"address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
"city": "FT. CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "270-956-4618",
"fax_number": "270-412-6889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "270-956-4618",
"fax_number": "270-412-6889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LILLIAM",
"middle_name": "ELISA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-05",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "5458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.