Provider Demographics
NPI:1699468132
Name:RHOADES, CHYNA (PLPC)
Entity type:Individual
Prefix:
First Name:CHYNA
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:CHYNA
Other - Middle Name:
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5609
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-0609
Mailing Address - Country:US
Mailing Address - Phone:417-455-5875
Mailing Address - Fax:
Practice Address - Street 1:1110 W HARMONY ST STE D
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-1638
Practice Address - Country:US
Practice Address - Phone:417-455-5875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023015669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health