| Firefly Counseling, Llc | |
|
2013 Willow Creek Dr Ste 2b Watertown SD 57201-9150 | |
| (605) 878-0376 | |
| Not Available |
| Full Name | Firefly Counseling, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2013 Willow Creek Dr Ste 2b, Watertown, South Dakota |
| Authorized Official Name and Position | Katherine Hendricks (NURSE PRACTITIONER) |
| Authorized Official Contact | 6052373717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Firefly Counseling, Llc 2028 Lanoue Cir Watertown SD 57201-5513 Ph: (605) 237-3717 | Firefly Counseling, Llc 2013 Willow Creek Dr Ste 2b Watertown SD 57201-9150 Ph: (605) 878-0376 |
| NPI Number | 1699346924 |
|---|---|
| Provider Enumeration Date | 07/07/2021 |
| Last Update Date | 12/01/2021 |
| Certification Date | 12/01/2021 |
| Medicare PECOS PAC ID | 6709284672 |
|---|---|
| Medicare Enrollment ID | O20211006002578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699346924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Lee M Hendricks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851795884 PECOS PAC ID: 5395062582 Enrollment ID: I20150327000819 |
| Provider Name | Katherine Hendricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750914677 PECOS PAC ID: 6507279106 Enrollment ID: I20201228001121 |
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