Provider Demographics
NPI:1891025441
Name:RHOADES, DEBRA MARIE (LCSW, CASAC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:RHOADES
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OKARA DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5721
Mailing Address - Country:US
Mailing Address - Phone:518-355-4135
Mailing Address - Fax:
Practice Address - Street 1:1362 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3017
Practice Address - Country:US
Practice Address - Phone:518-374-0295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO42054-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical