Enso Mental Health, Llc | |
211 N Main St Ste 104 Spearfish SD 57783-2646 | |
(605) 519-5850 | |
Not Available |
Full Name | Enso Mental Health, Llc |
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Speciality | Clinic/Center |
Location | 211 N Main St Ste 104, Spearfish, South Dakota |
Authorized Official Name and Position | Joanna Marye Prewitt (OWNER/PRESIDENT) |
Authorized Official Contact | 6055195850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Enso Mental Health, Llc Po Box 922 Spearfish SD 57783-0922 Ph: (695) 519-5850 | Enso Mental Health, Llc 211 N Main St Ste 104 Spearfish SD 57783-2646 Ph: (605) 519-5850 |
NPI Number | 1912541921 |
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Provider Enumeration Date | 11/01/2019 |
Last Update Date | 11/01/2019 |
Medicare PECOS PAC ID | 0749651883 |
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Medicare Enrollment ID | O20230127000531 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912541921 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Katy A Davis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1487266722 PECOS PAC ID: 8820409170 Enrollment ID: I20201118001089 |
Provider Name | Shannon Heather Howard |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1205108396 PECOS PAC ID: 5496199341 Enrollment ID: I20240219002249 |
Provider Name | Joanna M Prewitt |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1750802450 PECOS PAC ID: 5294106332 Enrollment ID: I20240222002119 |
Provider Name | Jessica Leigh Ruzicka |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1972026383 PECOS PAC ID: 4284071952 Enrollment ID: I20240318003175 |
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