Provider Demographics
NPI:1558494435
Name:RHODES, BROOKE COURTNEY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BROOKE
Middle Name:COURTNEY
Last Name:RHODES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5962 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:FORESTHILL
Mailing Address - State:CA
Mailing Address - Zip Code:95631-9602
Mailing Address - Country:US
Mailing Address - Phone:530-889-7263
Mailing Address - Fax:530-889-7253
Practice Address - Street 1:11512 B AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2605
Practice Address - Country:US
Practice Address - Phone:530-889-7263
Practice Address - Fax:530-889-7293
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical