Provider Demographics
NPI:1740342559
Name:RHODIN, VICTORIA (MSW)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:RHODIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:VT
Mailing Address - Zip Code:05065-0156
Mailing Address - Country:US
Mailing Address - Phone:802-291-9001
Mailing Address - Fax:802-291-9001
Practice Address - Street 1:5126 VT RTE 14
Practice Address - Street 2:OFFICE 6
Practice Address - City:SHARON
Practice Address - State:VT
Practice Address - Zip Code:05065
Practice Address - Country:US
Practice Address - Phone:802-291-9001
Practice Address - Fax:802-291-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT89-00004571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0RE5587Medicaid
NH30423715Medicaid
VT0RE5587Medicaid