Provider Demographics
NPI:1649334632
Name:RHODES, LAURA ANN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:RHODES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1607
Mailing Address - Country:US
Mailing Address - Phone:781-775-3420
Mailing Address - Fax:
Practice Address - Street 1:1 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1607
Practice Address - Country:US
Practice Address - Phone:781-775-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210768101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA210768OtherSOCIAL WORK