MEDICARE: NORMA K PANSCH MA, LPC-MH, QMHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC-MH30625	SD
2	101YP2500X	Professional Counselor	LPC200555	SD

General Provider Information

NPI Number	:	1740749803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA K PANSCH MA, LPC-MH, QMHP

Provider Business Mailing Address
First Line	:	PO BOX 250
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57709-0250
Country	:	US
Telephone Number	:	605-209-0446
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 W MAIN ST STE 305
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-2447
Country	:	US
Telephone Number	:	605-209-0446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	03/09/2023

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