Ms Tara L Jorgenson, MS,LPC,QMHP | |
11 4th St E, Lemmon, SD 57638-1524 | |
(605) 374-3862 | |
(605) 374-3864 |
Full Name | Ms Tara L Jorgenson |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 11 4th St E, Lemmon, South Dakota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841355039 | NPI | - | NPPES |
54523 | Medicaid | ND | |
1841355039 | Other | SD | NPI # APPLIED IN ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 552-1-01-06 (North Dakota) | Primary |
101YM0800X | Counselor - Mental Health | LPC1183 (South Dakota) | Primary |
Entity Name | West River Health Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174606271 PECOS PAC ID: 0042127045 Enrollment ID: O20040128001023 |
Entity Name | West River Health Services |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1588763247 PECOS PAC ID: 0042127045 Enrollment ID: O20100909000218 |
Mailing Address | Practice Location Address |
---|---|
Ms Tara L Jorgenson, MS,LPC,QMHP Po Box 447, 11 East 4th Street, Lemmon, SD 57638-0447 Ph: (605) 374-3862 | Ms Tara L Jorgenson, MS,LPC,QMHP 11 4th St E, Lemmon, SD 57638-1524 Ph: (605) 374-3862 |
Ms. Michelle L. Kennedy, MSW-CSW-QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 East 4th Street, Lemmon, SD 57638 Phone: 605-374-3862 Fax: 605-374-3864 | |
Gregory Fisher, CCDC-II Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 4th St E, Lemmon, SD 57638 Phone: 605-374-3862 Fax: 605-374-3864 | |
Thelma Claymore, CCDC-II Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 4th St E, Lemmon, SD 57638 Phone: 605-374-3862 Fax: 605-374-3864 | |
Mr. Patrick Poitra, LPC, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 East 4th St, Lemmon, SD 57645 Phone: 605-823-4212 Fax: 605-823-4212 | |
Mr. Allan Mcgough, MSW-LCSW-QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 4th St E, Lemmon, SD 57638 Phone: 605-374-3862 Fax: 605-374-3864 |