Agnes Dawn Rodriguez, PROVISIONAL LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-07111 Issued in NM

Practice address

2150 Highway 54 S
Alamogordo, NM 88310-7330

Phone

(575) 443-8133

Fax

(575) 443-8055

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Sky Counseling AssociatesGroup PAC ID 7012256175, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue Sky Counseling Associates

  • Professional Counselor
  • Alamogordo, NM
  • NPI 1154809283

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611446400000",
    "number": "1356579577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "HI RLS MTN PK",
            "state": "NM",
            "postal_code": "883250553",
            "telephone_number": "575-443-6166",
            "fax_number": "575-437-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HIGHWAY 54 S",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883107330",
            "telephone_number": "575-443-8133",
            "fax_number": "575-443-8055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Oregon Ave",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883105710",
            "country_code": "US",
            "telephone_number": "575-443-6166",
            "fax_number": "575-437-0755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AGNES",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "PROVISIONAL LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2021-01-24",
        "certification_date": "2021-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-07111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Rockwell
• Rocky Mountain Holdings, LLC
• Miriam Rodriguez Dominguez
• Susana Rodriguez Foster
• Lucia Rodriguez-Torres
• Alexis Rodriguez
• Ana Rodriguez, LCSW
• Ethel Rodriguez
• Kienna Rodriguez
• Rocio Rodriguez

• Clinical Social Worker in Alamogordo, NM
• Providers in Alamogordo, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.