| Lisa Ann Rodriguez, LCSW | |
|
811 E Humphrey Ave, Rock Falls, IL 61071-2020 | |
| (815) 275-0745 | |
| Not Available |
| Full Name | Lisa Ann Rodriguez |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 811 E Humphrey Ave, Rock Falls, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336816107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.01592 (Illinois) | Primary |
| Entity Name | Blue Moon Senior Counseling Of Illinois Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841562931 PECOS PAC ID: 7012172893 Enrollment ID: O20120628000431 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Ann Rodriguez, LCSW 811 E Humphrey Ave, Rock Falls, IL 61071-2020 Ph: (815) 275-0745 | Lisa Ann Rodriguez, LCSW 811 E Humphrey Ave, Rock Falls, IL 61071-2020 Ph: (815) 275-0745 |
Susan Wilhelm, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1300 W 2nd St, Rock Falls, IL 61071 Phone: 815-625-2230 | |
Mrs. Brooke Michelle Bruketta, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1300 W 2nd St, Rock Falls, IL 61071 Phone: 815-626-2230 | |
Ms. Tracy Marie Banks-geiger, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1300 W 2nd St, Rock Falls, IL 61071 Phone: 815-626-2232 | |
Mr. Douglas Eugene Mitchem, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1600 Riverdale Rd Lot 42, Rock Falls, IL 61071 Phone: 815-441-4195 | |
Mrs. Briena Wyckstandt, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1300 W 2nd St, Rock Falls, IL 61071 Phone: 815-626-2230 | |
David Bingaman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1300 W 2nd St, Rock Falls, IL 61071 Phone: 815-626-2230 |