Individual provider Active NPI

Christian Alcide Rodriguez, LCSW

  • Clinical Social Worker
  • Secaucus, NJ
National Provider Identifier
1568935294
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
094798 Issued in NY
Practice address
2111 Riverside Station Blvd
Secaucus, NJ 07094-4415
Phone
(917) 449-1735
NPI assigned
Jan 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06194500 NJ
Clinical Social Worker 1041C0700X 111099 TX
Clinical Social Worker 1041C0700X 094798 NY Primary

Addresses

Primary practice location

2111 Riverside Station Blvd
Secaucus, NJ 07094-4415

Mailing address

2111 Riverside Station Blvd
Secaucus, NJ 07094-4415
Phone (917) 449-1735

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06194500NJMDClinical Social Worker
094798NYMDClinical Social Worker
111099TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
My Light Home Psychotherapy LLC Clinical Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1568935294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 RIVERSIDE STATION BLVD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070944415",
            "telephone_number": "917-449-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 RIVERSIDE STATION BLVD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070944415",
            "telephone_number": "917-449-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CHRISTIAN",
        "middle_name": "ALCIDE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-04",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06194500",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "111099",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.