MEDICARE: HORSE SENSE COUNSELING 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1396373981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORSE SENSE COUNSELING LLC

Provider Business Mailing Address
First Line	:	PO BOX 9503
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57709-9503
Country	:	US
Telephone Number	:	605-431-3349
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 W MAIN ST STE 305
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-2447
Country	:	US
Telephone Number	:	605-431-8492
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	EVELYN WILDER
Credential	:	LPC-MH, QMHP, NCC
Telephone Number	:	605-431-3349

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	03/30/2020

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