Active NPI
Freddie Vazquez-Rodriguez, CASAC-G, LCSW (RI)
- Addiction (Substance Use Disorder) Counselor
- New York, NY
National Provider Identifier
1275958753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 19114
- Practice address
- 19 Union SQ W
Floor 7
New York, NY 10003-3304 - Phone
- (212) 627-9600
- Fax
- (212) 627-4040
- NPI assigned
- Feb 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 8673 | CT | |
| Social Worker | 104100000X | 150.112973 | IL | |
| Clinical Social Worker | 1041C0700X | CSW03457 | RI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 19114 | NY | Primary |
Addresses
Primary practice location
19 Union SQ W
Floor 7
New York, NY 10003-3304
Mailing address
9610 57TH Ave Apt Rome2J
Corona, NY 11368-3436
Phone (917) 804-6987
Other names 1
- Freddie Vazquez-Rodriguez
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19114 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| 150.112973 | IL | MD | Social Worker |
| CSW03457 | RI | MD | Clinical Social Worker |
| 8673 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Realization Center, Inc. | Past | Accepting new patients | |
| Realization Center | 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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- New York, NY
- NPI 1972932465
-
- Clinic/Center
- New York, NY
- NPI 1699827345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1275958753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9610 57TH AVE APT ROME2J",
"city": "CORONA",
"state": "NY",
"postal_code": "113683436",
"telephone_number": "917-804-6987",
"fax_number": "917-804-6987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 UNION SQ W",
"address_2": "FLOOR 7",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033304",
"telephone_number": "212-627-9600",
"fax_number": "212-627-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAZQUEZ-RODRIGUEZ",
"first_name": "FREDDIE",
"credential": "CASAC-G, LCSW (RI)",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-20",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "8673",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.112973",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "CSW03457",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "19114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "FREDDIE",
"last_name": "VAZQUEZ-RODRIGUEZ",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.