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NPI Code Detail

MEDICARE: MS. SHADEAU LEA RHODES LCSW

MEDICARE: MS. SHADEAU LEA RHODES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker11304TN
21041C0700XClinical Social Worker7952TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NAOTHERNA

General Provider Information

NPI Number : 1023778461
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHADEAU LEA RHODES LCSW
Provider Business Mailing Address
First Line : 152 TIMBER CREEK DR STE 4
Second Line :
City : CORDOVA
State : TN
Zip : 38018-4237
Country : US
Telephone Number : 901-308-6991
Fax Number :
Provider Business Practice Location Address
First Line : 152 TIMBER CREEK DR STE 4
Second Line :
City : CORDOVA
State : TN
Zip : 38018-4237
Country : US
Telephone Number : 901-308-6991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2021
Last Update Date : 12/11/2025

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Directions to “ MS. SHADEAU LEA RHODES LCSW” Practice Location

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