Doctor Name: | MS. IRENE MARIE RODGERS |
NPI Number: | 1033147509 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 072539 |
Business Practice Address: | 506 Stewart Ave Garden City, NY - 115304706 |
Business Phone Number: | 5167397733 |
Business Fax Number: | 5167393923 |
Mailing Address: | 23 Jackson Ave, BAYVILLE |
State: | NY |
Postal Code: | 117091333 |
Phone Number: | 5166283065 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 072539 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |