Healthcare Provider Details

I. General information

NPI: 1023075645
Provider Name (Legal Business Name): JODI ESTHER SALAZAR CSW-PIP MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: JODI WELSH

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W HAVENS STREET DAKOTA COUNSELING INSTITUTE
MITCHELL SD
57301
US

IV. Provider business mailing address

910 W HAVENS STREET DAKOTA COUNSELING INSTITUTE
MITCHELL SD
57301
US

V. Phone/Fax

Practice location:
  • Phone: 605-996-9686
  • Fax: 605-996-1624
Mailing address:
  • Phone: 605-996-9686
  • Fax: 605-996-1624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSWPIP 2118
License Number StateSD

VII. Legacy identifiers

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

# 1
Identifier0041708
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerWELLMARK BC/BS
# 2
Identifier21087
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerSIOUX VALLEY HEALTH
# 3
Identifier9221852
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerDAKOTACARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: