Provider Demographics
NPI:1568557452
Name:ROHDE, CONNIE G (LSCSW)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:G
Last Name:ROHDE
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 W 64TH TER
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3735
Mailing Address - Country:US
Mailing Address - Phone:913-954-0675
Mailing Address - Fax:
Practice Address - Street 1:7700 SHAWNEE MISSION PKWY STE 208
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-3057
Practice Address - Country:US
Practice Address - Phone:913-954-0675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
800010474OtherRAILROAD MEDICARE
22801040OtherBCBS OF KC
2927545BMedicare ID - Type Unspecified
800010474OtherRAILROAD MEDICARE
KS100098010Medicare ID - Type Unspecified