Provider Demographics
NPI:1972621472
Name:RHOADES, HAROLD G (PHD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:G
Last Name:RHOADES
Suffix:
Gender:M
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:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30639-0157
Mailing Address - Country:US
Mailing Address - Phone:706-246-0733
Mailing Address - Fax:706-246-0722
Practice Address - Street 1:63 SPRINGS STATION DRIVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30639
Practice Address - Country:US
Practice Address - Phone:706-246-0733
Practice Address - Fax:706-246-0722
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002156103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00836789AMedicaid
GA68BBFJWMedicare ID - Type UnspecifiedPSYCHOLOGIST