Rodriguez, Jacqueline
Rodriguez, Jacqueline is an sole proprietor health care provider with primary practice located at 243 Success Ave , Bridgeport CT 06610-2429. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Rodriguez, Jacqueline can be contacted via phone (203) 864-8429.Contact Information
Primary practice address
243 Success Ave
Bridgeport CT 06610-2429
Phone: (203) 864-8429
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 001104 | Connecticut |
Profile Details
| NPI number | 1003288168 |
|---|---|
| LBN Legal business name | Rodriguez, Jacqueline |
| Credentials | LADC,CAC,APP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 28th, 2015 |
| Last updated | Oct 31st, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003288168 | NPPES |
| Connecticut | Other | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | ICADC-5511 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | CAC-5511 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | APP-5511 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | HEALTHYCT WELLMORE GRP/FACILITY |
| Connecticut | MEDICAID | PENDING | HEALTHYCT WELLMORE GRP/FACILITY |
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