person
Mrs. Jacqueline Rodriguez, LADC,CAC,APP
Addiction (Substance Use Disorder) Counselor in Bridgeport, Connecticut
NPI 1003288168

Jacqueline Rodriguez is an Addiction (Substance Use Disorder) Counselor based in Bridgeport, CT and is specialized in Addiction (Substance Use Disorder). Jacqueline Rodriguez practices in Bridgeport, CT and has the professional credentials of LADC,CAC,APP. The NPI Number for Jacqueline Rodriguez is 1003288168 and holds a License No. 001104 (Connecticut).

The current practice location address for Jacqueline Rodriguez is 243 Success Ave, Bridgeport, CT and can be reached out via phone at 203-864-8429.

Location: 243 Success Ave, Bridgeport, CT, 06610-2429
person
Provider Profile Details
NPI Number
1003288168
Provider Name
Jacqueline Rodriguez
Credential
LADC,CAC,APP
Provider Entity Type
Individual
Gender
Female
Address
243 Success Ave, Bridgeport, CT, 06610-2429
Phone Number
203-864-8429
Fax Number
Provider Enumeration Date
10/28/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
060669107 01 CT HEALTHYCT WELLMORE GRP/FACILITY
060669107 01 CT UBH- CONNECTICARE WELLMORE GRP/FACILITY
060669107 01 CT UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
ICADC-5511 01 CT ICADC INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR CCB
CAC-5511 01 CT CAC- CERTIFIED ADDICTION COUNSELOR CCB
PENDING 01 CT AETNA BEHAVIORAL HEALTH
PENDING 01 CT CAQH
PENDING 01 CT MHN MANAGED HEALTH NETWORK
060669107 01 CT UNITED BEHAVIORAL HEALTH- OPTUM WELLMORE GRP/FACILITY
060669107 01 CT UBH-OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY
APP-5511 01 CT APP ASSOCIATE PREVENTION PROFESSIONAL CCB
060669107 01 CT ANTHEM BCBS OF CT WELLMORE GRP/FACILITY
PENDING 01 CT CIGNA BEHAVIORAL HEALTH
PENDING 01 CT MHN TRICARE NORTH
PENDING 05 CT
institution
Provider Business Practice Location Address Details
Address
243 Success Ave
City
State
Zip
06610-2429
Phone Number
203-864-8429
Fax Number
person
Provider Business Mailing Address Details
Address
243 Success Ave
City
State
Zip
06610-2429
Phone Number
203-864-8429
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
001104 (Connecticut)
Definition
Definition to come...
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