Provider Demographics
NPI:1649686320
Name:RODRIGUEZ, MARIBEL (LMHC)
Entity type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 LEE RD
Mailing Address - Street 2:D-104
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2240
Mailing Address - Country:US
Mailing Address - Phone:407-754-6967
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S HOME SOCIETY
Practice Address - Street 2:5768 S SEMORAN BLVD
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822
Practice Address - Country:US
Practice Address - Phone:407-896-2323
Practice Address - Fax:407-896-7760
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH11588101YM0800X
FLMH14886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health