Provider Demographics
NPI:1700374345
Name:REXRODE, DANA N (MA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:N
Last Name:REXRODE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5771 HEARDS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:COVESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22931-1639
Mailing Address - Country:US
Mailing Address - Phone:434-806-7707
Mailing Address - Fax:
Practice Address - Street 1:2340 COMMONWEALTH DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1634
Practice Address - Country:US
Practice Address - Phone:434-326-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional