Basic Information
| Provider Information | |||||||||
| NPI: | 1053488155 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAPUTO | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FESTUS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630281952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369312700 | ||||||||
| FaxNumber: | 6369315304 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 MUNICIPAL DR | ||||||||
| Address2: | |||||||||
| City: | ARNOLD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630101012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362966206 | ||||||||
| FaxNumber: | 6362960102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 07/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | 002245 | MO | N | Other Service Providers | Case Manager/Care Coordinator | 101YP2500X | 002245 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 495244709 | 05 | MO | MEDICAID |