Provider Demographics
NPI:1275741621
Name:RHODES, KIMBERLY CALVIN (LCPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CALVIN
Last Name:RHODES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 NORTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8860
Mailing Address - Country:US
Mailing Address - Phone:630-554-5296
Mailing Address - Fax:
Practice Address - Street 1:70 S RIVER ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-5295
Practice Address - Country:US
Practice Address - Phone:630-844-2662
Practice Address - Fax:630-844-3084
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health