Provider Demographics
NPI:1528186046
Name:HENRY-CLARKE, RHONIE VICTORIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RHONIE
Middle Name:VICTORIA
Last Name:HENRY-CLARKE
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 1:351 SILVER ST
Mailing Address - Street 2:BEERS HALL 3RD FLOOR
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3919
Mailing Address - Country:US
Mailing Address - Phone:860-262-6954
Mailing Address - Fax:860-262-5852
Practice Address - Street 1:351 SILVER ST
Practice Address - Street 2:BEERS HALL 3RD FLOOR
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3919
Practice Address - Country:US
Practice Address - Phone:860-262-6954
Practice Address - Fax:860-262-5852
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT006387OtherLCSW LICENSURE NUMBER