Healthcare Provider Details

I. General information

NPI: 1154296846
Provider Name (Legal Business Name): OPEN SPACES MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W MISSOURI AVE
PIERRE SD
57501-4506
US

IV. Provider business mailing address

111 W PARK AVE
FORT PIERRE SD
57532-2006
US

V. Phone/Fax

Practice location:
  • Phone: 605-280-9704
  • Fax:
Mailing address:
  • Phone: 605-280-9704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
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: JESSICA RAE FOTH
Title or Position: PRESIDENT
Credential: LCSW-PIP, LAC, QMHP
Phone: 605-280-9704