Individual provider Active NPI

Jessica Rodriguez

  • Social Worker
  • Elizabeth, NJ
National Provider Identifier
1821445255
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL05882200 Issued in NJ
Practice address
1020 Sheridan Ave
Elizabeth, NJ 07208-3044
Phone
(908) 659-6130
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00218900 NJ
Doula 374J00000X
Social Worker 104100000X 44SL05882200 NJ Primary

Addresses

Primary practice location

1020 Sheridan Ave
Elizabeth, NJ 07208-3044

Mailing address

1020 Sheridan Ave
Elizabeth, NJ 07208-3044
Phone (908) 659-6130

Other practice location 1

183 S Orange Ave
Newark, NJ 07103-2757
Phone (732) 235-5000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00218900NJMDAddiction (Substance Use Disorder) Counselor
44SL05882200NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1821445255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SHERIDAN AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083044",
            "telephone_number": "908-659-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SHERIDAN AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083044",
            "telephone_number": "908-659-6130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "183 S Orange Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032757",
            "country_code": "US",
            "telephone_number": "732-235-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00218900",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05882200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.