Provider Demographics
NPI:1447476189
Name:BARAHONA, RODRIGO (PSYA D LMHC LADC-1)
Entity type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:
Last Name:BARAHONA
Suffix:
Gender:M
Credentials:PSYA D LMHC LADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 BEACON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-4418
Mailing Address - Country:US
Mailing Address - Phone:617-501-1172
Mailing Address - Fax:
Practice Address - Street 1:1685 BEACON ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4418
Practice Address - Country:US
Practice Address - Phone:617-501-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2022-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6689101YM0800X, 101YM0800X
MA2127101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)