Provider Demographics
NPI:1881573129
Name:RHODES, TIMOTHY ROBERT (LLMSW)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:RHODES
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:TIMOTHY
Other - Middle Name:ROBERT
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 LAKE VILLAGE DR APT 306
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6543
Mailing Address - Country:US
Mailing Address - Phone:616-337-8808
Mailing Address - Fax:
Practice Address - Street 1:2020 HOGBACK RD STE 18
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9752
Practice Address - Country:US
Practice Address - Phone:517-481-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511205401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical