Individual provider Active NPI

Yvonne Marie Rodriguez, L.C.S.W.

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1821146507
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW3022 Issued in FL
Practice address
1729 W Las Olas Blvd
Fort Lauderdale, FL 33312-7518
Phone
(813) 404-7405
Fax
(000) 000-0000
NPI assigned
Jan 8, 2007
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW3022 FL
Clinical Social Worker 1041C0700X SW3022 FL Primary

Addresses

Primary practice location

1729 W Las Olas Blvd
Fort Lauderdale, FL 33312-7518

Mailing address

1729 W Las Olas Blvd
Fort Lauderdale, FL 33312-7518
Phone (813) 404-7405

Other identifiers 1

IdentifierTypeStateIssuer
Z6527OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180223002179 FL Practitioner - Clinical Social Worker 3375804842 Reassigns benefits to 1 organization
I20240103002089 DC Practitioner - Clinical Social Worker 3375804842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 22, 2023 Accepting new patients
Henderson Behavioral Health, Inc. PastSince Oct 9, 2017 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1821146507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 W LAS OLAS BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333127518",
            "telephone_number": "813-404-7405",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 W LAS OLAS BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333127518",
            "telephone_number": "813-404-7405",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "YVONNE",
        "middle_name": "MARIE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW3022",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z6527",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.