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NPI Code Detail

MEDICARE: COMMUNITY COUNSELING SERVICE

MEDICARE: COMMUNITY COUNSELING SERVICE
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
1101YA0400XAddiction (Substance Use Disorder) Counselor2SD
2101YM0800XMental Health Counselor1SD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S69975OTHERSDGROUP MEDICARE NUMBER

General Provider Information

NPI Number : 1932167277
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY COUNSELING SERVICE
Provider Business Mailing Address
First Line : 357 KANSAS AVE SE
Second Line :
City : HURON
State : SD
Zip : 57350-2517
Country : US
Telephone Number : 605-352-8596
Fax Number : 605-352-7001
Provider Business Practice Location Address
First Line : 357 KANSAS AVE SE
Second Line :
City : HURON
State : SD
Zip : 57350-2517
Country : US
Telephone Number : 605-352-8596
Fax Number : 605-352-7001
Authorized Official
Title or Position : ACCOUNTS RECEIVABLE
Name : SHELLY ROTERT
Credential :
Telephone Number : 605-352-8596
Provider Enumeration Date : 05/03/2006
Last Update Date : 08/09/2022

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1487761896 — ELIZABETH KELSEY ED.D., LPC-MH
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1790895282 — DUANE R MAJERES MS, LICENSED PSYCH.
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1649380148 — TAMMY T DRAMSTAD MSW, LCSW
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Directions to “COMMUNITY COUNSELING SERVICE ” Practice Location

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