Mrs Jacqueline Rodriguez, LADC,CAC,APP - Counselor in Bridgeport, CT

Mrs Jacqueline Rodriguez, LADC,CAC,APP is a Counselor - Addiction (substance Use Disorder) based in Bridgeport, Connecticut. Mrs Jacqueline Rodriguez is licensed to practice in Connecticut (license number 001104) and her current practice location is 243 Success Ave, Bridgeport, Connecticut. She can be reached at her office (for appointments etc.) via phone at (203) 864-8429.

NPI number for Mrs Jacqueline Rodriguez is 1003288168 and her current mailing address is 243 Success Ave, Bridgeport, Connecticut. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003288168.

Contact Information

Mrs Jacqueline Rodriguez, LADC,CAC,APP
243 Success Ave,
Bridgeport, CT 06610-2429
(203) 864-8429
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMrs Jacqueline Rodriguez
GenderFemale
SpecialityCounselor - Addiction (substance Use Disorder)
Location243 Success Ave, Bridgeport, Connecticut
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003288168
  • Provider Enumeration Date: 10/28/2015
  • Last Update Date: 10/31/2016

Medical Identifiers

Medical identifiers for Mrs Jacqueline Rodriguez such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003288168NPI-NPPES
060669107OtherCTHEALTHYCT WELLMORE GRP/FACILITY
060669107OtherCTUBH- CONNECTICARE WELLMORE GRP/FACILITY
060669107OtherCTUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
ICADC-5511OtherCTICADC INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR CCB
CAC-5511OtherCTCAC- CERTIFIED ADDICTION COUNSELOR CCB
PENDINGOtherCTAETNA BEHAVIORAL HEALTH
PENDINGOtherCTCAQH
PENDINGOtherCTMHN MANAGED HEALTH NETWORK
060669107OtherCTUNITED BEHAVIORAL HEALTH- OPTUM WELLMORE GRP/FACILITY
060669107OtherCTUBH-OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY
APP-5511OtherCTAPP ASSOCIATE PREVENTION PROFESSIONAL CCB
060669107OtherCTANTHEM BCBS OF CT WELLMORE GRP/FACILITY
PENDINGOtherCTCIGNA BEHAVIORAL HEALTH
PENDINGOtherCTMHN TRICARE NORTH
PENDINGMedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) 001104 (Connecticut)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jacqueline Rodriguez is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Jacqueline Rodriguez, LADC,CAC,APP
243 Success Ave,
Bridgeport, CT 06610-2429

Ph: (203) 864-8429
Mrs Jacqueline Rodriguez, LADC,CAC,APP
243 Success Ave,
Bridgeport, CT 06610-2429

Ph: (203) 864-8429

Reviews and Comments


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