Healthcare Provider Details

I. General information

NPI: 1013116508
Provider Name (Legal Business Name): VISION QUEST COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

961 1/2 MAIN ST VISION QUEST COUNSELING CENTER
STURGIS SD
57785-1620
US

IV. Provider business mailing address

961 1/2 MAIN STREET VISION QUEST COUNSELING CENTER
STURGIS SD
57785-1620
US

V. Phone/Fax

Practice location:
  • Phone: 605-641-1843
  • Fax: 605-716-1002
Mailing address:
  • Phone: 605-641-1843
  • Fax: 605-716-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLPC7006
License Number StateSD

VIII. Authorized Official

Name: MR. PATRICK D POWERS
Title or Position: MENTAL HEALTH THERAPIST
Credential: MA, LPC
Phone: 605-641-1843