Provider Demographics
NPI:1437648177
Name:RHODES, BRIONNE (LCPC)
Entity type:Individual
Prefix:
First Name:BRIONNE
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 STONEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-3940
Mailing Address - Country:US
Mailing Address - Phone:618-367-5376
Mailing Address - Fax:618-345-6577
Practice Address - Street 1:907 N BLUFF RD STE 9
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-5816
Practice Address - Country:US
Practice Address - Phone:618-345-9644
Practice Address - Fax:618-345-6577
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional