Provider Demographics
NPI:1255883617
Name:RHYNE, ELIZABETH PAIGE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:PAIGE
Last Name:RHYNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:RHYNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3371 CARBINEER DR
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-9731
Mailing Address - Country:US
Mailing Address - Phone:618-303-2666
Mailing Address - Fax:779-666-8044
Practice Address - Street 1:1643 N ALPINE RD UNIT 104-108
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-1462
Practice Address - Country:US
Practice Address - Phone:618-303-2666
Practice Address - Fax:779-666-8044
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.102104104100000X
IL149.0205681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker