Provider Demographics
NPI:1790940369
Name:SALLY E RHOADS LCSW PSC
Entity Type:Organization
Organization Name:SALLY E RHOADS LCSW PSC
Other - Org Name:FAMILY CONNECTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSC
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:RHOADS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-263-2673
Mailing Address - Street 1:121 PROSPEROUS PL
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1800
Mailing Address - Country:US
Mailing Address - Phone:859-263-2673
Mailing Address - Fax:859-263-5677
Practice Address - Street 1:121 PROSPEROUS PL
Practice Address - Street 2:SUITE 4A
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1800
Practice Address - Country:US
Practice Address - Phone:859-263-2673
Practice Address - Fax:859-263-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty