Provider Demographics
NPI:1891052692
Name:RHOADES, CHERI L (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:L
Last Name:RHOADES
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:
Other - Last Name:HEUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:607 AIRPORT NORTH OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-6706
Mailing Address - Country:US
Mailing Address - Phone:260-413-1628
Mailing Address - Fax:260-432-8503
Practice Address - Street 1:607 AIRPORT NORTH OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-6706
Practice Address - Country:US
Practice Address - Phone:260-413-1628
Practice Address - Fax:260-432-8503
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002632A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300046566Medicaid