Provider Demographics
NPI:1992098024
Name:RHODES, TINA MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:RHODES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6851 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-5308
Mailing Address - Country:US
Mailing Address - Phone:804-715-3215
Mailing Address - Fax:
Practice Address - Street 1:6851 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-5308
Practice Address - Country:US
Practice Address - Phone:804-715-3215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health