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General NPI Number Information
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NPI Number | 1790940369
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Entity Type | Organization
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Legal Business Name | SALLY E RHOADS LCSW PSC
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 121 PROSPEROUS PL SUITE 4A
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City | LEXINGTON
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State | KY
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Zip | 40509-1800
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Country | US
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Telephone | 859-263-2673
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Fax | 859-263-5677
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Provider Business Mailing Address
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Address Line | 121 PROSPEROUS PL SUITE 4A
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City | LEXINGTON
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State | KY
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Zip | 40509-1800
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Country | US
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Telephone | 859-263-2673
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Fax | 859-263-5677
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Authorized Official
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Title or Position | PSC
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Name | MRS. SALLY ELIZABETH RHOADS
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Credential | LCSW
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Telephone | 859-263-2673
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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 | 238
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License Number State | KY
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