Active NPI
Michelle Evette Rodriguez, LMFT
- Marriage & Family Therapist
- Georgetown, TX
National Provider Identifier
1467926972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 203675
- Practice address
- 1504 Leander Rd
Georgetown, TX 78628-8801 - Phone
- (512) 337-9399
- NPI assigned
- Jan 17, 2019
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 203675 | TX | Primary |
Addresses
Primary practice location
1504 Leander Rd
Georgetown, TX 78628-8801
Mailing address
PO Box 1453
Bastrop, TX 78602-1453
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203675 | Other | TX | TEXAS STATE BOARD OF MARRIAGE AND FAMILY THERAPISTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 23, 2024 through Jan 23, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 203675 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1467926972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1453",
"city": "BASTROP",
"state": "TX",
"postal_code": "786021453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 LEANDER RD",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786288801",
"telephone_number": "512-337-9399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "MICHELLE",
"middle_name": "EVETTE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-17",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "203675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF MARRIAGE AND FAMILY THERAPISTS",
"identifier": "203675",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
- Rockdale Blackhawk LLC (Richards Memorial Hospital)
- Rockdale Blackhawk LLC (Little River Healthcare Georgetown Imaging)
- Rocky Hollow Cabins, LLC (Rocky Hollow Lake House)
- Tiara Joy Rodgers, CPM
- Rodriguez Dental Services PLLC
- Teresa Rodriguez, OTR
- Jermaine Caballes Pinzon Rogalski
- Roger Taylor Management (Chiropractic Center of Georgetown)
- Jennifer Alyene Rogers, MD
- Sabine H Rogers
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.