Provider Demographics
NPI:1144735572
Name:RHODES, JASON DANIEL (CDCA, QMHS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:DANIEL
Last Name:RHODES
Suffix:
Gender:M
Credentials:CDCA, QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3445
Mailing Address - Country:US
Mailing Address - Phone:740-941-6539
Mailing Address - Fax:
Practice Address - Street 1:2266 WAKEFIELD MOUND RD
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-9660
Practice Address - Country:US
Practice Address - Phone:740-941-6539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)