Healthcare Provider Details

I. General information

NPI: 1013432368
Provider Name (Legal Business Name): JULIA RHODES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 07/08/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 RAYOVAC DR STE 103
MADISON WI
53711
US

IV. Provider business mailing address

1015 MOUND ST UNIT 106
MADISON WI
53715-1684
US

V. Phone/Fax

Practice location:
  • Phone: 608-238-5826
  • Fax:
Mailing address:
  • Phone: 720-939-8016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130760-121
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9366-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: