Provider Demographics
NPI:1215378153
Name:RHODES, JENNIFER ROSE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:RHODES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 MELROSE LN
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35453-2363
Mailing Address - Country:US
Mailing Address - Phone:205-393-7713
Mailing Address - Fax:205-469-9343
Practice Address - Street 1:423 SKYLAND BLVD STE A7
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-4000
Practice Address - Country:US
Practice Address - Phone:205-202-0724
Practice Address - Fax:205-469-9343
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4188C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical