Provider Demographics
NPI:1003918814
Name:RHOADS, BETH A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:A
Last Name:RHOADS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-1210
Mailing Address - Country:US
Mailing Address - Phone:215-316-2255
Mailing Address - Fax:
Practice Address - Street 1:121 WAVERLY RD
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1210
Practice Address - Country:US
Practice Address - Phone:215-316-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00152900101YP2500X
PAPC001745101YP2500X
DEB1-0001000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2321371000OtherIBC
PA7832313OtherAETNA
PA280626000OtherKEYSTONE