Provider Demographics
NPI:1548533805
Name:WILLIAMS-RODRIGUE, JENY LYNN (LAC)
Entity type:Individual
Prefix:MRS
First Name:JENY
Middle Name:LYNN
Last Name:WILLIAMS-RODRIGUE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 SHREWSBURY RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-3523
Mailing Address - Country:US
Mailing Address - Phone:504-462-1302
Mailing Address - Fax:504-298-5052
Practice Address - Street 1:2201 SEVERN AVE APT H210
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7619
Practice Address - Country:US
Practice Address - Phone:504-462-1302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2018-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1527101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)