Jacqueline Rae Rodriguez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

200 Ike Dr
Makawao, HI 96768-9718

Phone

(808) 579-8414

NPI assigned

Jan 23, 2023

Last updated

Jan 23, 2023By the provider in NPPES

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

Other names 1

• Jackie Rae Rodriguez Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aloha House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Makawao, HI
  • NPI 1457642076
  NPD
• Maui Youth and Family Services Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Makawao, HI
  • NPI 1205838539
  NPD (past)

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1528773702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 LOWER KULA RD",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967908821",
            "telephone_number": "808-446-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 IKE DR",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967689718",
            "telephone_number": "808-579-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACQUELINE",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrrodriguez@aloha-house.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 Ike Dr",
            "city": "Makawao",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967689718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "RODRIGUEZ",
            "middle_name": "RAE",
            "credential": "MSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina Marie Ricchi, LMT
• Nancy Kelly Rice, L.AC.
• Richard M Sword PHD Inc
• Eva Rickord, M.A.
• Robert Mastroianni MD Inc
• Cynthia Elizabeth Rose, LMT
• Meri Angela Rosen, D.C.
• Rina Kojima Rousek, APRN
• Patricia Jo Ryan, MFT, PHD
• Scott Sadler, APRN

• Mental Health Counselor in Makawao, HI
• Providers in Makawao, HI by specialty
• Mental Health Counselor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.