Individual provider Active NPI

Candice Marie Rodriguez, LPC

  • Professional Counselor
  • Glenwood Springs, CO
National Provider Identifier
1972952315
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0013713 Issued in CO
Practice address
1905 Blake Ave Ste 101
Glenwood Springs, CO 81601-4206
Phone
(970) 945-2840
Fax
(970) 945-2893
NPI assigned
Jun 7, 2016
Last updated
Jan 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.011800 IL
Professional Counselor 101YP2500X 0013713 CO Primary

Addresses

Primary practice location

1905 Blake Ave Ste 101
Glenwood Springs, CO 81601-4206

Mailing address

6250 W North Ave
Chicago, IL 60639-3861
Phone (773) 622-6218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250828003094 CO Practitioner - Mental Health Counselor 9032610316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1003 Alabaster CV
Sanford, FL 32771-3607

440 N Barranca Ave
Covina, CA 91723-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0013713COMDProfessional Counselor
178.011800ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Clinic CT PLLC CurrentSince Jul 9, 2025 Accepting new patients

Locations

440 N Barranca Ave
Covina, CA 91723
Phone (510) 210-5030

870 S Colorado Blvd
#1067
Denver, CO 80246
Phone (248) 704-5837

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, 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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1972952315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393861",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BLAKE AVE STE 101",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014206",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.011800",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0013713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

Verify at the official NPI Registry.