MEDICARE: RCS EXCLUSIVE THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1013771062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RCS EXCLUSIVE THERAPY, LLC

Provider Business Mailing Address
First Line	:	823 NW 208TH TER
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2142
Country	:	US
Telephone Number	:	954-559-0011
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 NW 208TH TER
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2142
Country	:	US
Telephone Number	:	954-559-0011
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	CAROLINA LEON
Credential	:	LMHC,LMFT,NCC,QS
Telephone Number	:	954-559-0011

Provider Enumeration Date	:	02/09/2024
Last Update Date	:	02/09/2024

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