Nancy Y Rodriguez-Lora, LCSW
Individual provider Active NPI Mental Health Counselor · Goshen, IN
NPI 1336148477 · NPPES record last updated May 7, 2008
Key facts
- NPI
- 1336148477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 34004716A (IN)
- Practice address
- 400 West Lincoln Ave.
Goshen, IN 46526-4723 - Phone
- (574) 533-7133
- Fax
- (574) 533-7666
- NPI assigned
- Jul 20, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 34004716A | IN | Yes |
Addresses
Primary practice location
400 West Lincoln Ave.
Goshen, IN 46526-4723
Mailing address
65818 Harwood Dr
Goshen, IN 46526-8997
Phone (574) 536-6229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200535420A | Medicaid | IN |
Other providers in Goshen, IN
- Deborah W. Risa
- Taylor Allison Risser
- Jasmin Rivas
- Danielle Mary Robertson
- Cynthia Nathaly Robling
- Ana Luisa Rodriguez-Sandoval
- Kylee Rohatgi
- Jacob E Rohn I
- Ronald Abaro DDS PC
- Kristin Marie Roos
All providers in Goshen, IN · Mental Health Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.