Provider Demographics
NPI:1386181592
Name:RHODES, ALEX LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:LEE
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:PO BOX 56284
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91413-1284
Mailing Address - Country:US
Mailing Address - Phone:858-442-9893
Mailing Address - Fax:
Practice Address - Street 1:555 MARIN ST STE 180
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4104
Practice Address - Country:US
Practice Address - Phone:626-701-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84469101YM0800X, 104100000X
171M00000X, 390200000X
CA989821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA98982OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES (BBS)