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General NPI Number Information
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NPI Number | 1912629320
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Entity Type | Organization
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Legal Business Name | RCSQUARED ENTERPRISES, LLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 150 SAINT PETERS CENTRE BLVD STE B
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City | SAINT PETERS
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State | MO
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Zip | 63376-1653
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Country | US
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Telephone | 615-830-7546
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Fax | 877-767-3926
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Provider Business Mailing Address
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Address Line | 425 WILLOWBROOK BND
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-9674
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Country | US
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Telephone | 270-703-8917
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Fax | 877-767-3926
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | JANICE WADE
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Credential | LMFT
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Telephone | 636-345-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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