Healthcare Provider Details

I. General information

NPI: 1457013641
Provider Name (Legal Business Name): INTERIOR WEST COUNSELING L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 08/01/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 EGLIN ST STE 200
RAPID CITY SD
57701-9632
US

IV. Provider business mailing address

PO BOX 110
MARTIN SD
57551-0110
US

V. Phone/Fax

Practice location:
  • Phone: 605-570-5922
  • Fax: 605-309-7839
Mailing address:
  • Phone: 605-570-5922
  • Fax: 605-309-7839

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: SARAH MONICH HINKLE
Title or Position: OWNER
Credential: LCSW
Phone: 406-241-3758