Amanda Maria Rodriguez, CSAC, CSIT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16021-132 Issued in WI

Practice address

5735 Durand Ave
Mount Pleasant, WI 53406-5011

Phone

(262) 598-1392

Fax

(262) 598-1395

NPI assigned

Apr 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Quality Addiction Management Inc

  • Methadone Clinic
  • Kenosha, WI
  • NPI 1184354979
  NPD (past)
• Quality Addiction Management Inc

  • Methadone Clinic
  • Green Bay, WI
  • NPI 1629282470

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1629412580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 DURAND AVE",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065011",
            "telephone_number": "262-598-1392",
            "fax_number": "262-598-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 DURAND AVE",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065011",
            "telephone_number": "262-598-1392",
            "fax_number": "262-598-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AMANDA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "CSAC, CSIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15693-133",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16021-132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100037952",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelo B Reyes, M.D.
• Amber Rae Rice, OCCUPATIONAL THERAPI
• Patricia Rivera, M.D.
• Meredith Robinette, OTR
• Jason Paul Robinson, RN
• Francisco J Rodriguez, RDH
• Rachel R Rogatzki, PA
• Stacy Lee Roland, RN
• Jessica Lorinne Romano, DDS
• Jonathan Rosario, PSY.D.

• Addiction (Substance Use Disorder) Counselor in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.