Provider Demographics
NPI:1548948565
Name:RODRIGUEZ-VARGAS, CAROLINA (LMSW)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:RODRIGUEZ-VARGAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:RODRIGUEZ-LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2201 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-6731
Mailing Address - Country:US
Mailing Address - Phone:936-585-0079
Mailing Address - Fax:
Practice Address - Street 1:320 NORTH ST STE 206
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5018
Practice Address - Country:US
Practice Address - Phone:936-244-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108006104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker