Provider Demographics
NPI:1184044588
Name:RHOADES, DANIEL MATTHEW JR (ASW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MATTHEW
Last Name:RHOADES
Suffix:JR
Gender:M
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 BRODERICK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3304
Mailing Address - Country:US
Mailing Address - Phone:415-292-1762
Mailing Address - Fax:
Practice Address - Street 1:1421 BRODERICK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3304
Practice Address - Country:US
Practice Address - Phone:415-292-1762
Practice Address - Fax:415-292-1636
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 172V00000X, 390200000X
CAASW117834104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program