Depue, Jade Rachael
Depue, Jade Rachael is an sole proprietor health care provider with primary practice located at 925 Madison Street , Jefferson City MO 65101. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Depue, Jade Rachael can be contacted via phone (573) 634-3432.Contact Information
Primary practice address
925 Madison Street
Jefferson City MO 65101
Phone: (573) 634-3432
Fax: (636) 898-0951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 2016011184 | Missouri |
Profile Details
| NPI number | 1316391097 |
|---|---|
| LBN Legal business name | Depue, Jade Rachael |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2016 |
| Last updated | Oct 21st, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316391097 | NPPES |
| Missouri | MEDICAID | 490031448 |
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