Provider Demographics
NPI:1730283011
Name:RHOADES, PATRICK A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:A
Last Name:RHOADES
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 1:414 SE FOURTH STREET
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713
Mailing Address - Country:US
Mailing Address - Phone:812-423-4700
Mailing Address - Fax:812-421-2618
Practice Address - Street 1:414 SE FOURTH STREET
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713
Practice Address - Country:US
Practice Address - Phone:812-423-4700
Practice Address - Fax:812-421-2618
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002204A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000296311OtherANTHEM BCBS