Healthcare Provider Details

I. General information

NPI: 1346912334
Provider Name (Legal Business Name): CASCADE COUNSELING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 E NEW YORK ST STE 2
RAPID CITY SD
57701-6501
US

IV. Provider business mailing address

328 E NEW YORK ST STE 2
RAPID CITY SD
57701-6501
US

V. Phone/Fax

Practice location:
  • Phone: 605-453-5451
  • Fax:
Mailing address:
  • Phone: 605-453-5451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RANDY DUANE ALLEN
Title or Position: THERAPIST
Credential: CSW-PIP
Phone: 605-718-9241