MEDICARE: TORNO MEDIATION & MENTAL HEALTH SERVICES, LLC

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	101YM0800X	Mental Health Counselor	LPC-MH 2284	SD

General Provider Information

NPI Number	:	1164890661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TORNO MEDIATION & MENTAL HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	324 SAINT JOSEPH ST STE 202
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-2829
Country	:	US
Telephone Number	:	605-718-3613
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 SAINT JOSEPH ST STE 202
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-2829
Country	:	US
Telephone Number	:	605-718-3613
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND MENTAL HEALTH THERAPIST
Name	:	MELANIE TORNO
Credential	:	MS LPC-MH QMHP
Telephone Number	:	605-718-3613

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	09/14/2015

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