MEDICARE: ERICA LEIGH FETT LCSW-PIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6036	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093316168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LEIGH FETT LCSW-PIP

Provider Business Mailing Address
First Line	:	115 N 7TH ST STE 6
Second Line	:
City	:	SPEARFISH
State	:	SD
Zip	:	57783-2710
Country	:	US
Telephone Number	:	605-645-0100
Fax Number	:	605-717-1009

Provider Business Practice Location Address
First Line	:	2525 W MAIN ST STE 210
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-2439
Country	:	US
Telephone Number	:	605-645-0100
Fax Number	:	605-717-1009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	01/20/2026

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