Provider Demographics
NPI:1508235839
Name:RHODES, AIMEE MONIQUE (LPC-S)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:MONIQUE
Last Name:RHODES
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:538 LIVELY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2809
Mailing Address - Country:US
Mailing Address - Phone:903-312-2818
Mailing Address - Fax:
Practice Address - Street 1:11550 W INTERSTATE 10 STE 155
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1035
Practice Address - Country:US
Practice Address - Phone:210-201-4578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
TX68851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349381903Medicaid