Healthcare Provider Details

I. General information

NPI: 1760435572
Provider Name (Legal Business Name): STEVE MARC RHODES MSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 MAIN ST
GREENFIELD MA
01301-3238
US

IV. Provider business mailing address

52 MARY POTTER LN
GREENFIELD MA
01301-9746
US

V. Phone/Fax

Practice location:
  • Phone: 413-834-5794
  • Fax: 413-773-9301
Mailing address:
  • Phone: 413-834-5794
  • Fax: 413-773-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1030509
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: