NPIMap

Organization Active NPI

Rcsquared Enterprises, LLC

Doing business as Ellie Mental Health of St. Peters

  • Professional Counselor
  • Saint Peters, MO
National Provider Identifier
1912629320
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
RCSQUARED ENTERPRISES, LLC
Doing business as
Ellie Mental Health of St. Peters
Practice address
150 Saint Peters Centre Blvd Ste B
Saint Peters, MO 63376-1653
Phone
(615) 830-7546
Fax
(877) 767-3926
NPI assigned
Sep 13, 2022
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Janice Wade, LMFTNPI 1831890060
Title
Clinic Director
Phone
(636) 345-4744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU Primary
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X NU
Counseling Psychologist 103TC1900X NU
Group Psychotherapy Psychologist 103TP2701X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Psychoanalyst 102L00000X NU

Addresses

Primary practice location

150 Saint Peters Centre Blvd Ste B
Saint Peters, MO 63376-1653

Mailing address

425 Willowbrook BND
Cape Girardeau, MO 63701-9674
Phone (270) 703-8917

Other names 1

  • Ellie Mental Health of St. Peters Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250820004021 MO Part B Supplier - Clinic/Group Practice 2264932730 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Peters, MO

National Provider Directory

National Provider Directory

Locations

150 Saint Peters Centre Blvd
Ste B
Saint Peters, MO 63376
Phone (636) 336-6171

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1912629320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 WILLOWBROOK BND",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637019674",
            "telephone_number": "270-703-8917",
            "fax_number": "877-767-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SAINT PETERS CENTRE BLVD STE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761653",
            "telephone_number": "615-830-7546",
            "fax_number": "877-767-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RCSQUARED ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "636-345-4744",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health of St. Peters",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellie Mental Health of St. Peters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.