Healthcare Provider Details

I. General information

NPI: 1295506731
Provider Name (Legal Business Name): REBECCA MICHELLE CLAYMORE MS LPC QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA MICHELLE BUESCHER MS

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 WATERLOO ST
RAPID CITY SD
57701-1656
US

IV. Provider business mailing address

2036 2ND AVE
RAPID CITY SD
57702-3322
US

V. Phone/Fax

Practice location:
  • Phone: 605-277-3750
  • Fax: 605-718-4878
Mailing address:
  • Phone: 636-352-8649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20968
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: