Rhode, Sara Rose

Rhode, Sara Rose is an individual health care provider with primary practice located at 571 County Road A , Green Lake WI 54941. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Rhode, Sara Rose can be contacted via phone (920) 294-4070.

Contact Information

Primary practice address
571 County Road A Green Lake WI 54941
Phone: (920) 294-4070
Fax: (920) 294-4139
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 9169-123 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12046-132 Wisconsin

Profile Details

NPI number 1821597311
LBN Legal business name Rhode, Sara Rose
Credentials LCSW, CSAC, ICS
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2018
Last updated May 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821597311 NPPES
Wisconsin MEDICAID 100075650
Wisconsin Other 15375-134
Wisconsin Other 100080162

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