Provider Demographics
NPI:1275549057
Name:RODE, DEBRA ELEANOR (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ELEANOR
Last Name:RODE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12555 ORANGE DR
Mailing Address - Street 2:SUITE 267
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4304
Mailing Address - Country:US
Mailing Address - Phone:954-862-3644
Mailing Address - Fax:954-472-3027
Practice Address - Street 1:12555 ORANGE DR
Practice Address - Street 2:SUITE 267
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:954-862-3644
Practice Address - Fax:954-472-3027
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3828101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health