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NPI Code Detail

MEDICARE: MR. BROOKE COURTNEY RHODES LCSW

MEDICARE: MR. BROOKE COURTNEY RHODES 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
11041C0700XClinical Social Worker61551CA

General Provider Information

NPI Number : 1558494435
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BROOKE COURTNEY RHODES LCSW
Provider Business Mailing Address
First Line : 5962 ARROWHEAD DR
Second Line :
City : FORESTHILL
State : CA
Zip : 95631-9602
Country : US
Telephone Number : 530-889-7263
Fax Number : 530-889-7253
Provider Business Practice Location Address
First Line : 11512 B AVE
Second Line :
City : AUBURN
State : CA
Zip : 95603-2605
Country : US
Telephone Number : 530-889-7263
Fax Number : 530-889-7293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 05/22/2014

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