Provider Demographics
NPI:1255594826
Name:FERNANDES, RHEA M (LCSW)
Entity type:Individual
Prefix:
First Name:RHEA
Middle Name:M
Last Name:FERNANDES
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 1:2910 FRANKS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4253
Mailing Address - Country:US
Mailing Address - Phone:215-947-8654
Mailing Address - Fax:215-938-7607
Practice Address - Street 1:2910 FRANKS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4253
Practice Address - Country:US
Practice Address - Phone:215-947-8654
Practice Address - Fax:215-938-7607
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health