Provider Demographics
NPI:1750774840
Name:RHOADS, JONATHAN MICHAEL (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:RHOADS
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8105 LILLY STONE DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-4570
Mailing Address - Country:US
Mailing Address - Phone:301-639-4036
Mailing Address - Fax:
Practice Address - Street 1:8105 LILLY STONE DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-4570
Practice Address - Country:US
Practice Address - Phone:301-639-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD169531041C0700X
DCLC500799991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical