Provider Demographics
NPI:1134653215
Name:RHOADES, AMY (MSW, LCSW, BSN, RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:MSW, LCSW, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 PINE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-8688
Mailing Address - Country:US
Mailing Address - Phone:724-549-4925
Mailing Address - Fax:
Practice Address - Street 1:351 PINE RIDGE LN
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-8688
Practice Address - Country:US
Practice Address - Phone:724-549-4925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN684160163W00000X
PACW0217271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse