Healthcare Provider Details

I. General information

NPI: 1275278160
Provider Name (Legal Business Name): SAVANNAH GRACE RHODES MS, NCC, LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 CHESTNUT GROVE RD
BELLEFONTE PA
16823-4300
US

IV. Provider business mailing address

2502 CHESTNUT GROVE RD
BELLEFONTE PA
16823-4300
US

V. Phone/Fax

Practice location:
  • Phone: 814-933-9714
  • Fax:
Mailing address:
  • Phone: 814-933-9714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC000364
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: