Provider Demographics
NPI:1235622135
Name:RODRIGUEZ, LILYSBEL (LMHC)
Entity type:Individual
Prefix:MRS
First Name:LILYSBEL
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 1:1020 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4411
Mailing Address - Country:US
Mailing Address - Phone:786-243-1003
Mailing Address - Fax:
Practice Address - Street 1:1020 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4411
Practice Address - Country:US
Practice Address - Phone:786-243-1003
Practice Address - Fax:786-243-0503
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH16008OtherBOARD OF MSW/MFT/MHC