Provider Demographics
NPI:1669678157
Name:RHODES, CARLA M (LSW)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:RHODES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1214
Mailing Address - Country:US
Mailing Address - Phone:724-238-0355
Mailing Address - Fax:724-238-0352
Practice Address - Street 1:117 JUNIPER LN
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-9727
Practice Address - Country:US
Practice Address - Phone:724-238-0355
Practice Address - Fax:724-238-0352
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123515104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker