Provider Demographics
NPI:1861299786
Name:RODRIGUEZ, ALEXIE RAE (LSW)
Entity type:Individual
Prefix:
First Name:ALEXIE
Middle Name:RAE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E ORANGE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-1937
Mailing Address - Country:US
Mailing Address - Phone:717-806-5050
Mailing Address - Fax:717-806-5179
Practice Address - Street 1:215 E STATE ST
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-1268
Practice Address - Country:US
Practice Address - Phone:717-806-5050
Practice Address - Fax:717-806-5179
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139264104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty