Provider Demographics
NPI:1679258487
Name:DR. CHALICE C. RHODES, LICENSED PROFESSIONAL COUNSELOR, LLC
Entity type:Organization
Organization Name:DR. CHALICE C. RHODES, LICENSED PROFESSIONAL COUNSELOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHALICE
Authorized Official - Middle Name:C
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:856-441-3177
Mailing Address - Street 1:5 BRYCE RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1629
Mailing Address - Country:US
Mailing Address - Phone:856-441-3177
Mailing Address - Fax:
Practice Address - Street 1:5 BRYCE RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1629
Practice Address - Country:US
Practice Address - Phone:856-441-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty