Provider Demographics
NPI:1083766083
Name:RHODES, PAMELA JANE (MSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JANE
Last Name:RHODES
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4847 E VIRGINIA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2611
Mailing Address - Country:US
Mailing Address - Phone:812-479-1242
Mailing Address - Fax:812-479-1330
Practice Address - Street 1:4847 E VIRGINIA ST
Practice Address - Street 2:SUITE B
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2611
Practice Address - Country:US
Practice Address - Phone:812-479-1242
Practice Address - Fax:812-479-1330
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005268A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical