Healthcare Provider Details

I. General information

NPI: 1215847587
Provider Name (Legal Business Name): SCARLETT MARIE BAINBRIDGE CSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 MOUNT RUSHMORE RD
RAPID CITY SD
57701-8931
US

IV. Provider business mailing address

4044 DERBY LN UNIT 1
RAPID CITY SD
57701-2139
US

V. Phone/Fax

Practice location:
  • Phone: 605-343-5422
  • Fax:
Mailing address:
  • Phone: 831-205-9697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120313
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7161
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: