Provider Demographics
NPI:1891505566
Name:RHOADS, MISTY LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:LYNN
Last Name:RHOADS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-2239
Mailing Address - Country:US
Mailing Address - Phone:217-273-2419
Mailing Address - Fax:
Practice Address - Street 1:913 LAKE LAND BLVD
Practice Address - Street 2:
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-5521
Practice Address - Country:US
Practice Address - Phone:217-273-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor