Basic Information
Provider Information
NPI: 1225302623
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RHYNDRESS
FirstName: JOELLEN
MiddleName: EVANS
NamePrefix: MRS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 376 E APPLE AVE
Address2:  
City: MUSKEGON
State: MI
PostalCode: 494423466
CountryCode: US
TelephoneNumber: 2317243699
FaxNumber: 2317244188
Practice Location
Address1: 204 CHARLOTTE HWY STE F
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288038681
CountryCode: US
TelephoneNumber: 8283335708
FaxNumber: 8284841025
Other Information
ProviderEnumerationDate: 03/02/2012
LastUpdateDate: 02/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X6801093141MIY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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