Provider Demographics
NPI:1588209746
Name:TYUS, RHONDA JEAN (MFT INTERN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:TYUS
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8531 CHERIE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2048
Mailing Address - Country:US
Mailing Address - Phone:937-718-8905
Mailing Address - Fax:
Practice Address - Street 1:24100 CHAGRIN BLVD STE 125
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-714-3278
Practice Address - Fax:800-879-1741
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.1900172-TRNE101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty