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General NPI Number Information
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NPI Number | 1558494435
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Entity Type | Individual
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Provider Name | BROOKE COURTNEY RHODES LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 11512 B AVE
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City | AUBURN
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State | CA
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Zip | 95603-2605
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Country | US
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Telephone | 530-889-7263
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Fax | 530-889-7293
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Provider Business Mailing Address
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Address Line | 5962 ARROWHEAD DR
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City | FORESTHILL
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State | CA
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Zip | 95631-9602
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Country | US
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Telephone | 530-889-7263
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Fax | 530-889-7253
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 61551
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License Number State | CA
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