Provider Demographics
NPI:1356475339
Name:RHOADS, SALLY ELIZABETH (LCSW, BCD)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:ELIZABETH
Last Name:RHOADS
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:MRS
Other - First Name:SALLY
Other - Middle Name:ELIZABETH
Other - Last Name:RHOADS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, PSC
Mailing Address - Street 1:121 PROSPEROUS PL
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1800
Mailing Address - Country:US
Mailing Address - Phone:859-263-2673
Mailing Address - Fax:
Practice Address - Street 1:121 PROSPEROUS PL
Practice Address - Street 2:SUITE 4A
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1800
Practice Address - Country:US
Practice Address - Phone:859-263-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY2381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical