Provider Demographics
NPI:1750468385
Name:RHODES, MARK A (LPC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:RHODES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173684
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76003-3684
Mailing Address - Country:US
Mailing Address - Phone:817-233-6939
Mailing Address - Fax:817-563-7427
Practice Address - Street 1:1160 COUNTRY CLUB LN # 1160
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2008
Practice Address - Country:US
Practice Address - Phone:817-361-7201
Practice Address - Fax:817-361-7521
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17947101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10037201OtherAMERIGROUP PIN
TX00G981OtherBCBSTX GRP PIN
1336198894OtherGRP NPI NUMBER
TX5669761OtherFIRSTHEALTH PIN
TX153863906Medicaid
TX84762LOtherBCBST IND PIN
TX135391OtherSUPERIOR PIN