| Rosebud Therapy Services LLC | |
|
7200 Manchester Rd Maplewood MO 63143-2403 | |
| (314) 292-9873 | |
| Not Available |
| Full Name | Rosebud Therapy Services LLC |
|---|---|
| Speciality | Social Worker |
| Location | 7200 Manchester Rd, Maplewood, Missouri |
| Authorized Official Name and Position | Mary B Hennicke (SOLE MEMBER) |
| Authorized Official Contact | 3142929873 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosebud Therapy Services LLC 6747 Pernod Ave Saint Louis MO 63139-2115 Ph: (314) 954-8372 | Rosebud Therapy Services LLC 7200 Manchester Rd Maplewood MO 63143-2403 Ph: (314) 292-9873 |
| NPI Number | 1619855251 |
|---|---|
| Provider Enumeration Date | 08/22/2025 |
| Last Update Date | 08/22/2025 |
| Certification Date | 08/22/2025 |
| Medicare PECOS PAC ID | 1557862414 |
|---|---|
| Medicare Enrollment ID | O20250902000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619855251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Mary Bridget Hennicke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396566337 PECOS PAC ID: 2466953328 Enrollment ID: I20250902000344 |
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