Individual provider Active NPI

Jaime Rodriguez, LMFT

  • Marriage & Family Therapist
  • Wolcott, CT
National Provider Identifier
1477824415
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001496 Issued in CT
Practice address
1495 Wolcott Rd
Wolcott, CT 06716-1321
Phone
(203) 879-4424
Fax
(203) 879-4442
NPI assigned
Jan 23, 2012
Last updated
Jan 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001496 CT Primary

Addresses

Primary practice location

1495 Wolcott Rd
Wolcott, CT 06716-1321

Mailing address

PO Box 453
Bristol, CT 06011-0453
Phone (203) 879-4424

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

LicenseStateTypeSpecialty
001496CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Counseling LLC Marriage & Family Therapist PastSince Jun 23, 2024 Accepting new patients
Collaborative Counseling, LLC Marriage & Family Therapist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1477824415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 453",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060110453",
            "telephone_number": "203-879-4424",
            "fax_number": "203-879-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067161321",
            "telephone_number": "203-879-4424",
            "fax_number": "203-879-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAIME",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolcott, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.