Individual provider Active NPI

Lenaida Rodriguez, MS, LMFT, LCDC

  • Marriage & Family Therapist
  • San Antonio, TX
National Provider Identifier
1679395230
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
204078 Issued in TX
Practice address
14802 Jones Maltsberger Rd Ste 1101
San Antonio, TX 78247-3571
Phone
(210) 490-4419
NPI assigned
Oct 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16101 TX
Marriage & Family Therapist 106H00000X 204078 TX Primary

Addresses

Primary practice location

14802 Jones Maltsberger Rd Ste 1101
San Antonio, TX 78247-3571

Mailing address

9614 Krier VW
Converse, TX 78109-1958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 9, 2024 through Jul 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16101TXMDChiropractor
204078TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Vine Wellness Group, LLC CurrentSince Oct 27, 2024 Accepting new patients

Locations

14802 Jones Maltsberger Rd
Ste 1101
San Antonio, TX 78247
Phone (210) 315-3684

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": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1679395230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9614 KRIER VW",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781091958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14802 JONES MALTSBERGER RD STE 1101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473571",
            "telephone_number": "210-490-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LENAIDA",
        "credential": "MS, LMFT, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "16101",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.