Provider Demographics
NPI:1306838941
Name:RHODE, DAVID LEROY (LMHP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEROY
Last Name:RHODE
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 S 159TH AVENUE CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1967
Mailing Address - Country:US
Mailing Address - Phone:402-333-9215
Mailing Address - Fax:
Practice Address - Street 1:1246 GOLDEN GATE DR
Practice Address - Street 2:STE 2
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2838
Practice Address - Country:US
Practice Address - Phone:402-339-2544
Practice Address - Fax:402-339-4358
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health