Evelyn Rodriguez, M.ED

Primary specialty

Social WorkerTaxonomy code 104100000X

License

1777 Issued in CT

Practice address

141 E Main St
3Rd Floor Home Based Services
Waterbury, CT 06702-2310

Phone

(203) 575-0466

Fax

(203) 575-1817

NPI assigned

Apr 15, 2014

Last updated

Aug 15, 2016By 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 identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

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.

• The Charlotte Hungerford Hospital

  • General Acute Care Hospital
  • Torrington, CT
  • NPI 1629075734
  Medicare reassignment NPD
• The Charlotte Hungerford Hospital

  • Psychiatric Hospital Unit
  • Torrington, CT
  • NPI 1639255870
  NPD
• Wellmore, Inc.

  • Counselor
  • Waterbury, CT
  • NPI 1477983179
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1649699851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "3RD FLOOR HOME BASED SERVICES",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-575-0466",
            "fax_number": "203-575-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "EVELYN",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "1777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13671482",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOOMFIELD SCHOOL DISTRICT-PROVISIONAL EDUCATOR",
            "identifier": "PROVISIONAL EDUCATOR",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008062548",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis M. Rodin, M.D.
• Nexcy Rodriguez Rivera, BA
• Rosarimar Rodriguez Santiago, PSYD
• Atneciv Rodriguez
• Cristina Rodriguez, MSW,BA,LMSW
• Ingrid Joann Rodriguez, LMSW
• Kayla Rodriguez, LPN
• Kimberly Alexis Rodriguez, LCSW
• Roberto Emanuel Rodriguez, LMSW
• Samnaya Rodriguez

• Social Worker in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.