Healthcare Provider Details

I. General information

NPI: 1851116727
Provider Name (Legal Business Name): NATHAN RHODES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 RIDGE MILL DR
HILLIARD OH
43026-7752
US

IV. Provider business mailing address

412 CROSSINGS DR
WESTERVILLE OH
43082-6339
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-7876
  • Fax:
Mailing address:
  • Phone: 614-551-8696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2406252-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: