Provider Demographics
NPI:1417496316
Name:SIMPSON-RHOADS, DEIRDRE (LCSW)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:
Last Name:SIMPSON-RHOADS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 BIRCH AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-1417
Mailing Address - Country:US
Mailing Address - Phone:541-801-3808
Mailing Address - Fax:360-844-5184
Practice Address - Street 1:1440 BIRCH AVE STE 8
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-1417
Practice Address - Country:US
Practice Address - Phone:541-801-3808
Practice Address - Fax:360-844-5184
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL113241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500720823Medicaid