Active NPI
Juan M Rodriguez, LPC
- Professional Counselor
- Fort Johnson, LA
National Provider Identifier
1629534920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8059
- Practice address
- 1585 3Rd St
Fort Johnson, LA 71459-5102 - Phone
- (337) 531-3517
- NPI assigned
- Feb 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 77726 | TX | |
| Professional Counselor | 101YP2500X | 8059 | LA | Primary |
Addresses
Primary practice location
1585 3Rd St
Fort Johnson, LA 71459-5102
Mailing address
1585 3Rd St BLDG 285
Fort Polk, LA 71459-5102
Phone (337) 531-2799
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3933079 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8059 | LA | MD | Professional Counselor |
| 77726 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1629534920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1585 3RD ST BLDG 285",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714595102",
"telephone_number": "337-531-2799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 3RD ST",
"city": "FORT JOHNSON",
"state": "LA",
"postal_code": "714595102",
"telephone_number": "337-531-3517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JUAN",
"middle_name": "M",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-12",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "77726",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "8059",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3933079",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Johnson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.