Active NPI
Mildred Ilene Rodriguez, LAC
- Professional Counselor
- Summit, NJ
National Provider Identifier
1700645033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37AC00503700
- Practice address
- 37 Maple St
Summit, NJ 07901-2529 - Phone
- (732) 674-9857
- NPI assigned
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37AC00503700 | NJ | Primary |
Addresses
Primary practice location
37 Maple St
Summit, NJ 07901-2529
Mailing address
37 Maple St
Summit, NJ 07901-2529
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 |
|---|---|---|---|
| 37AC00503700 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stellar Counseling Services | Professional | Current | Accepting new patients |
Locations
37 Maple St
Summit, NJ 07901
Phone (908) 273-7909
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": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1700645033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 MAPLE ST",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "079012529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 MAPLE ST",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "079012529",
"telephone_number": "732-674-9857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "MILDRED",
"middle_name": "ILENE",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37AC00503700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summit, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.