Healthcare Provider Details

I. General information

NPI: 1619281375
Provider Name (Legal Business Name): DAKOTA HILLS COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 E NEW YORK ST
RAPID CITY SD
57701-1566
US

IV. Provider business mailing address

24 E NEW YORK ST
RAPID CITY SD
57701-1566
US

V. Phone/Fax

Practice location:
  • Phone: 605-342-0504
  • Fax:
Mailing address:
  • Phone: 605-342-0504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1806
License Number StateSD

VII. Legacy identifiers

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

# 1
Identifier1104892785
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerNPI INDIVIDUAL
# 2
Identifier4995473
Identifier TypeOTHER
Identifier State
Identifier IssuerBLUE CROSS
# 3
Identifier9233748
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerDAKOTACARE
# 4
Identifier6571042
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name: MS. EILEEN SPELLACY LEIR
Title or Position: PRESIDENT
Credential: MSW
Phone: 605-342-0504