| Clegg Counseling Llc | |
|
611 Dahl Rd Ste 8 Spearfish SD 57783-2739 | |
| (605) 641-7534 | |
| Not Available |
| Full Name | Clegg Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 611 Dahl Rd Ste 8, Spearfish, South Dakota |
| Authorized Official Name and Position | Tracie Erin Bren-clegg (OWNER) |
| Authorized Official Contact | 6056417534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clegg Counseling Llc 611 Dahl Rd Ste 8 Spearfish SD 57783-2739 Ph: (605) 641-7534 | Clegg Counseling Llc 611 Dahl Rd Ste 8 Spearfish SD 57783-2739 Ph: (605) 641-7534 |
| NPI Number | 1992493514 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/15/2023 |
| Certification Date | 05/15/2023 |
| Medicare PECOS PAC ID | 2961852066 |
|---|---|
| Medicare Enrollment ID | O20240102003513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992493514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tracie Erin Bren-clegg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528255585 PECOS PAC ID: 3870943970 Enrollment ID: I20240102003552 |
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