Provider Demographics
NPI:1659406460
Name:RHODES, SANDRA S (PSY D)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:S
Last Name:RHODES
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:SOVERN
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:950 S CHERRY ST
Mailing Address - Street 2:#314
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2663
Mailing Address - Country:US
Mailing Address - Phone:303-399-8459
Mailing Address - Fax:303-399-4639
Practice Address - Street 1:950 S CHERRY ST
Practice Address - Street 2:#314
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2663
Practice Address - Country:US
Practice Address - Phone:303-399-8459
Practice Address - Fax:303-399-4639
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07105851Medicaid
CO94116Medicare ID - Type Unspecified