Pamela L Rodely, PATH CERTIFIED
Individual provider Active NPI Community/Behavioral Health Agency · Makanda, IL
NPI 1134940331 · NPPES record last updated Oct 21, 2024
Key facts
- NPI
- 1134940331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 830 Rowan Rd
Makanda, IL 62958-2849 - Phone
- (618) 607-4110
- NPI assigned
- Oct 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialized Equine Services and Therapeutic Riding Corporation | Community/Behavioral Health | Current |
Accepting new patients |
| Pam Rodely | Community/Behavioral Health | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
830 Rowan Rd
Makanda, IL 62958-2849
Mailing address
PO Box 520
Carterville, IL 62918-0520
Phone (618) 607-4110
Other providers in Makanda, IL
- Syhemia Sarah Gray-Cruz
- Living in a Family Environment Management Corporation
- Lindsay Meverden
- Pam Rodely
- John Spencer Phelps
- Specialized Equine Services and Therapeutic Riding Corporation
- Terry Eugene Sullivan
- Ramona Twellman
- Benjamin Mark Wrase
- Kenneth Ray Young
All providers in Makanda, IL · Community/Behavioral Health Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.