Provider Demographics
NPI:1982701892
Name:RHODY, KATHRYN HAYNES (EDD, LPC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:HAYNES
Last Name:RHODY
Suffix:
Gender:F
Credentials:EDD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BROOKSTONE CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-5515
Mailing Address - Country:US
Mailing Address - Phone:757-874-7273
Mailing Address - Fax:
Practice Address - Street 1:12725 MCMANUS BLVD
Practice Address - Street 2:BLDG 2, STE F & G
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4402
Practice Address - Country:US
Practice Address - Phone:757-874-1676
Practice Address - Fax:757-874-2226
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001204101YP2500X
VA0717000059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0870036OtherSENTARA MENTAL HEALTH MAN
3454-5897OtherUBH
231332OtherMAMSI
VA056208OtherANTHEM MEDICARE ADVANTAGE
7883201OtherAETNA
07495900OtherMBC
IP150624OtherGREEN SPRING HEALTH
323433OtherMHN
VA54-0076-7Medicaid
000148OtherVALUE OPTIONS
VA056208OtherANTHEM BC/BS