NPIMap

Organization Active NPI

Ic2 Therapy, PLLC.

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1770168254
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
IC2 THERAPY, PLLC.
Doing business as
IC2 Therapy, PLLC.
Practice address
5512 S Pin Oak Dr.
Tucson, AZ 85746
Phone
(520) 276-0062
NPI assigned
Mar 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Christina I Rodriguez, LCSWNPI 1407388143
Title
Psychotherapist
Phone
(520) 276-0062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5512 S Pin Oak Dr.
Tucson, AZ 85746

Mailing address

5512 S Pin Oak Dr.
Tucson, AZ 85746
Phone (152) 022-9780

Other names 1

  • IC2 Therapy, PLLC. Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL webroot

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1770168254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 S PIN OAK DR.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85746",
            "telephone_number": "152-022-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 S PIN OAK DR.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85746",
            "telephone_number": "520-276-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IC2 THERAPY, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "520-276-0062",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "webroot",
            "affiliation": "N",
            "address_1": "5512 S Pin Oak Dr.",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "85746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "IC2 Therapy, PLLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.