Healthcare Provider Details

I. General information

NPI: 1679381040
Provider Name (Legal Business Name): DENNIS TIMOTHY NOLF CSW-PIP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SAINT JOSEPH ST STE 201
RAPID CITY SD
57701-3304
US

IV. Provider business mailing address

909 SAINT JOSEPH ST STE 201
RAPID CITY SD
57701-3304
US

V. Phone/Fax

Practice location:
  • Phone: 605-299-9100
  • Fax:
Mailing address:
  • Phone: 231-715-9176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7067
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: