Provider Demographics
NPI:1972189199
Name:RODRIGUEZ, JESSICA GARAY (LMFT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:GARAY
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 WEST AVE STE 1105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1359
Mailing Address - Country:US
Mailing Address - Phone:210-293-0883
Mailing Address - Fax:210-352-9210
Practice Address - Street 1:11230 WEST AVE STE 1105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1359
Practice Address - Country:US
Practice Address - Phone:210-293-0883
Practice Address - Fax:210-352-9210
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15147101YA0400X
TX203869106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)