Healthcare Provider Details

I. General information

NPI: 1649083528
Provider Name (Legal Business Name): RACHEL COMSTOCK CSW-PIP, QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 S CLIFF AVE
SIOUX FALLS SD
57105-4031
US

IV. Provider business mailing address

2412 S CLIFF AVE
SIOUX FALLS SD
57105-4031
US

V. Phone/Fax

Practice location:
  • Phone: 813-293-2833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW19891
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6421
License Number StateSD

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: