Provider Demographics
NPI:1053336008
Name:RODRICK, HEIDI K (LCSW, LCADC)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:K
Last Name:RODRICK
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 ATLANTIC AVE
Mailing Address - Street 2:SUITE F5
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1029
Mailing Address - Country:US
Mailing Address - Phone:732-223-3131
Mailing Address - Fax:732-223-6262
Practice Address - Street 1:1913 ATLANTIC AVE
Practice Address - Street 2:SUITE F5
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1029
Practice Address - Country:US
Practice Address - Phone:732-223-3131
Practice Address - Fax:732-223-6262
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051797001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical