Provider Demographics
NPI:1235924192
Name:RODRIGUEZ, CAROLINA (MSW, PEL, LSW)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:MSW, PEL, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 OAKTON LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-6653
Mailing Address - Country:US
Mailing Address - Phone:847-373-2796
Mailing Address - Fax:
Practice Address - Street 1:126 OAKTON LN
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-6653
Practice Address - Country:US
Practice Address - Phone:847-373-2796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool