Provider Demographics
NPI:1467623892
Name:RUMBLE, PATRICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:RUMBLE
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 1:4600 S SPRINGHILL JCT
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4584
Mailing Address - Country:US
Mailing Address - Phone:812-242-2244
Mailing Address - Fax:812-242-2210
Practice Address - Street 1:4600 S SPRINGHILL JCT
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4584
Practice Address - Country:US
Practice Address - Phone:812-242-2244
Practice Address - Fax:812-242-2210
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000659A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN344840A6Medicare PIN