Active NPI
Tania Rhoads, CISW, SAC
- Social Worker
- Fond Du Lac, WI
National Provider Identifier
1043507346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 901-122
- Practice address
- 17 Forest Ave
Suite 116
Fond Du Lac, WI 54935-4155 - Phone
- (920) 907-0813
- Fax
- (920) 907-0826
- NPI assigned
- Jul 7, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15431-131 | WI | |
| Social Worker | 104100000X | 901-122 | WI | Primary |
Addresses
Primary practice location
17 Forest Ave
Suite 116
Fond Du Lac, WI 54935-4155
Mailing address
17 Forest Ave
Suite 116
Fond Du Lac, WI 54935-4155
Phone (920) 907-0813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15431-131 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 901-122 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309996800000",
"number": "1043507346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 FOREST AVE",
"address_2": "SUITE 116",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549354155",
"telephone_number": "920-907-0813",
"fax_number": "920-907-0826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 FOREST AVE",
"address_2": "SUITE 116",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549354155",
"telephone_number": "920-907-0813",
"fax_number": "920-907-0826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHOADS",
"first_name": "TANIA",
"credential": "CISW, SAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-07",
"last_updated": "2011-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15431-131",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "901-122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.