Provider Demographics
NPI:1508624081
Name:RHODEN, JODI ELIZABETH (LSW, CAADC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:ELIZABETH
Last Name:RHODEN
Suffix:
Gender:F
Credentials:LSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5245 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-1601
Mailing Address - Country:US
Mailing Address - Phone:828-236-9462
Mailing Address - Fax:
Practice Address - Street 1:5245 N 15TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-1601
Practice Address - Country:US
Practice Address - Phone:828-236-9462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker