Provider Demographics
NPI:1588966782
Name:RHODEN, KEITHA A (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KEITHA
Middle Name:A
Last Name:RHODEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:KEITHA
Other - Middle Name:A
Other - Last Name:CARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2094 PITKIN AVE
Mailing Address - Street 2:1ST FLOOR ( BEHAVIORAL HEALTH)
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-3509
Mailing Address - Country:US
Mailing Address - Phone:718-240-0600
Mailing Address - Fax:718-240-0601
Practice Address - Street 1:2094 PITKIN AVE
Practice Address - Street 2:1ST FLOOR ( BEHAVIORAL HEALTH)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3509
Practice Address - Country:US
Practice Address - Phone:718-240-0600
Practice Address - Fax:718-240-0601
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720762441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical