Individual ProviderGuadalupe Declet RodriguezCounselorBehavioral Health & Social Service ProvidersPractice Address1903 Humankind Way, Lynchburg, VA 24503-6313(434) 846-1124PECOS EnrollmentBased on the most recent information from CMS, provider Guadalupe Declet Rodriguez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1992423693Provider TypeIndividualFull NameDeclet Rodriguez, GuadalupeGenderFemaleSole ProprietorNoEnumeration Date8/18/2022Last Updated8/18/2022Contact InformationPractice LocationPractice Address1903 Humankind Way, Lynchburg, VA 24503-6313Phone(434) 846-1124Fax(434) 846-1052Mailing LocationMailing Address1903 Humankind Way, Lynchburg, VA 24503-6313Phone(434) 846-1124Fax(434) 846-1052Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense0701011710VirginiaProvider IdentifiersIDDescriptionIssuerIDA60426548DescriptionOtherIssuerDRIVER'S LICENSEVirginia