Provider Demographics
NPI:1053625384
Name:KIDNEY, RHONDA MICHELE (LPC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:MICHELE
Last Name:KIDNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:MICHELE
Other - Last Name:HOUDEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 645
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-0645
Mailing Address - Country:US
Mailing Address - Phone:971-301-5097
Mailing Address - Fax:
Practice Address - Street 1:808 NW BUCHANAN AVE STE 1
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6260
Practice Address - Country:US
Practice Address - Phone:971-301-5097
Practice Address - Fax:971-345-8015
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500776565Medicaid