Individual
MR. J SCOTT RHULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCSW, CSAC, ICS
Contact information
Practice address
111 WARREN ST STE 2, BEAVER DAM, WI 53916-3084
(920) 219-4440
(920) 219-4553
Mailing address
111 WARREN ST STE 2, BEAVER DAM, WI 53916-3084
(920) 219-4440
(920) 219-4553
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11335
WI
104100000X
Social Worker
Primary
2285
WI
1041C0700X
Clinical Social Worker
2284-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11335-132
CLINICAL SUBSTANCE ABUSE COUNSELOR (CSAC)
WI
01
—
11644-135
INDEPENDENT CLINICAL SUPERVISOR (ICS)
WI
01
—
2284-123
LCSW LICENSE
WI
01
—
32008
LICENSED MARRIAGE AND FAMILY THERAPIST (LMFT) INACTIVE STATUS
CA
05
—
40970600
—
WI
Enumeration date
08/19/2006
Last updated
03/13/2019
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