Healthcare Provider Details

I. General information

NPI: 1619370715
Provider Name (Legal Business Name): THE COUNSELING PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 MOUNT RUSHMORE RD
CUSTER SD
57730-1930
US

IV. Provider business mailing address

538 MOUNT RUSHMORE RD
CUSTER SD
57730-1930
US

V. Phone/Fax

Practice location:
  • Phone: 605-517-0519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JULIE SAPIENZA
Title or Position: CLINICAL SOCIAL WORKER
Credential:
Phone: 605-517-0519