Provider Demographics
NPI:1740167659
Name:RODRIGUEZ, DANIELLE JASMINE (LCPC)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:JASMINE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 MIDDLETON AVE
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1328
Mailing Address - Country:US
Mailing Address - Phone:773-310-1189
Mailing Address - Fax:
Practice Address - Street 1:2600 RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2725
Practice Address - Country:US
Practice Address - Phone:708-317-5926
Practice Address - Fax:708-637-4316
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180017122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health