Provider Demographics
NPI:1730283482
Name:SHALOM, RHODA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RHODA
Middle Name:
Last Name:SHALOM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 CAMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436
Mailing Address - Country:US
Mailing Address - Phone:561-732-4918
Mailing Address - Fax:561-732-4920
Practice Address - Street 1:400 E LINTON BLVD
Practice Address - Street 2:CENTER FOR FAMILY SERVICES
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483
Practice Address - Country:US
Practice Address - Phone:561-330-2266
Practice Address - Fax:561-330-2264
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00029701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24945Medicare ID - Type Unspecified