Provider Demographics
NPI:1164882577
Name:RCR COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:RCR COUNSELING SERVICES LLC
Other - Org Name:THE ROSE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-817-5029
Mailing Address - Street 1:156 E BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8179
Mailing Address - Country:US
Mailing Address - Phone:813-817-5029
Mailing Address - Fax:
Practice Address - Street 1:156 E BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8179
Practice Address - Country:US
Practice Address - Phone:813-817-5029
Practice Address - Fax:813-643-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW52691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL76690710Medicaid