Provider Demographics
NPI:1922459320
Name:GADDIS, RHONDA (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:GADDIS
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 1:108 N MINERAL TER
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-3216
Mailing Address - Country:US
Mailing Address - Phone:352-270-8674
Mailing Address - Fax:
Practice Address - Street 1:108 N MINERAL TER
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-3216
Practice Address - Country:US
Practice Address - Phone:352-270-8674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW111061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical