| Jennifer J. Kozel, Phd, Lcp, Inc. | |
|
1818 W Fulton St Ste. 201 Rapid City SD 57702-4377 | |
| (605) 348-6500 | |
| (605) 341-7409 |
| Full Name | Jennifer J. Kozel, Phd, Lcp, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1818 W Fulton St, Rapid City, South Dakota |
| Authorized Official Name and Position | Jennifer J. Kozel (PRESIDENT) |
| Authorized Official Contact | 6053486500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer J. Kozel, Phd, Lcp, Inc. 1818 W Fulton St Ste. 201 Rapid City SD 57702-4377 Ph: (605) 348-6500 | Jennifer J. Kozel, Phd, Lcp, Inc. 1818 W Fulton St Ste. 201 Rapid City SD 57702-4377 Ph: (605) 348-6500 |
| NPI Number | 1780950956 |
|---|---|
| Provider Enumeration Date | 03/31/2012 |
| Last Update Date | 03/31/2012 |
| Medicare PECOS PAC ID | 8022274505 |
|---|---|
| Medicare Enrollment ID | O20120727000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780950956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 432 (South Dakota) | Primary |
| Provider Name | Jennifer J Kozel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932137262 PECOS PAC ID: 2365608841 Enrollment ID: I20120730000348 |
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