MEDICARE: DR. KATHLEEN MARIA RHODES PH.D., L.F.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	1884	FL
2	106H00000X	Marriage & Family Therapist	MT 1788	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104153311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN MARIA RHODES PH.D., L.F.M.T.

Provider Business Mailing Address
First Line	:	4121 NW 5TH ST
Second Line	:	SUITE #206
City	:	PLANTATION
State	:	FL
Zip	:	33317-2120
Country	:	US
Telephone Number	:	954-797-5222
Fax Number	:	954-797-7677

Provider Business Practice Location Address
First Line	:	4121 NW 5TH ST
Second Line	:	SUITE #206
City	:	PLANTATION
State	:	FL
Zip	:	33317-2120
Country	:	US
Telephone Number	:	954-797-5222
Fax Number	:	954-797-7677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2009

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