Provider Demographics
NPI:1982393666
Name:JOLLEY, RHEA DOROTHEA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:RHEA
Middle Name:DOROTHEA
Last Name:JOLLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 PARK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5634
Mailing Address - Country:US
Mailing Address - Phone:443-378-0300
Mailing Address - Fax:443-738-0301
Practice Address - Street 1:1040 PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5634
Practice Address - Country:US
Practice Address - Phone:443-378-0300
Practice Address - Fax:443-738-0301
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG13172104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker