Marivelisse Rodriguez-Rivera, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

36317 Issued in TX

Practice address

7859 Walnut Hill LN Ste 200
Dallas, TX 75230

Phone

(214) 360-9044

Fax

(214) 666-3181

NPI assigned

Oct 27, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kids Brain, LLC

  • Clinical Child & Adolescent Psychologist
  • Dallas, TX
  • NPI 1528218120
  NPD (past)

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1871879445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 SWISS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75204",
            "telephone_number": "214-820-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7859 WALNUT HILL LN STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "214-360-9044",
            "fax_number": "214-666-3181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Empire Central Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752474022",
            "country_code": "US",
            "telephone_number": "214-867-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ-RIVERA",
        "first_name": "MARIVELISSE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68019362",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36317",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "36317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angiebel Marie Rodriguez-Cabral, M.S., PSY.D.
• Waren Omar Rodriguez-Carlo, DMD
• Diana Rodriguez-Carrillo
• Linda Rodriguez-Gilmore, FNP
• Myriam Janet Rodriguez-Laguer, M.D.
• Roberto Rodriguez-Ruesga, M.D.
• Aide Rodriguez
• Alejandra Patricia Rodriguez
• Alexandra Victoria Rodriguez, RN
• Amy Yamileth Rodriguez

• Clinical Neuropsychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.