Provider Demographics
NPI:1235305533
Name:ROCKWOOD COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:ROCKWOOD COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:AMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:636-938-9192
Mailing Address - Street 1:700 NIEHOFF DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-2166
Mailing Address - Country:US
Mailing Address - Phone:636-938-9192
Mailing Address - Fax:636-938-5642
Practice Address - Street 1:700 NIEHOFF DR
Practice Address - Street 2:SUITE B
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-2166
Practice Address - Country:US
Practice Address - Phone:636-938-9192
Practice Address - Fax:636-938-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS002441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO336404OtherVALUE OPTIONS
MO282452OtherMHN
MO486600OtherHEALTHLINK (NON PAR)
MO113783OtherBLUE CROSS / BLUE SHIELD
MO140673OtherCMR
MO213958000OtherMAGELLAN
MO492625034AMBOtherMERCY HEALTH PLAN
MO6298062OtherUNITED HEALTHCARE (UNITED BEHAVIORAL HEALTH)