MEDICARE: JOANNA RODES LCSW

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	104100000X	Social Worker	1513	KY
2	1041C0700X	Clinical Social Worker	1513	KY

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	:	1376698373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA RODES LCSW

Provider Business Mailing Address
First Line	:	501 DARBY CREEK RD STE 1
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1605
Country	:	US
Telephone Number	:	859-576-7678
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 DARBY CREEK RD STE 1
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1605
Country	:	US
Telephone Number	:	859-576-7678
Fax Number	:

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/02/2023

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Directions to “ JOANNA RODES LCSW” Practice Location

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