Provider Demographics
NPI:1104153311
Name:RHODES, KATHLEEN MARIA (PHD, LFMT)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARIA
Last Name:RHODES
Suffix:
Gender:F
Credentials:PHD, LFMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 NW 5TH ST
Mailing Address - Street 2:SUITE #206
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2120
Mailing Address - Country:US
Mailing Address - Phone:954-797-5222
Mailing Address - Fax:954-797-7677
Practice Address - Street 1:4121 NW 5TH ST
Practice Address - Street 2:SUITE #206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2120
Practice Address - Country:US
Practice Address - Phone:954-797-5222
Practice Address - Fax:954-797-7677
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1884101YA0400X
FLMT 1788106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)