| Lisa Porisch, Lpc-mh, Inc. | |
|
1818 W Fulton St Ste 201 Rapid City SD 57702-4347 | |
| (605) 348-6500 | |
| Not Available |
| Full Name | Lisa Porisch, Lpc-mh, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1818 W Fulton St Ste 201, Rapid City, South Dakota |
| Authorized Official Name and Position | Lisa Porisch (OWNER) |
| Authorized Official Contact | 6053486500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Porisch, Lpc-mh, Inc. 1818 W Fulton St Ste 201 Rapid City SD 57702-4347 Ph: (605) 348-6500 | Lisa Porisch, Lpc-mh, Inc. 1818 W Fulton St Ste 201 Rapid City SD 57702-4347 Ph: (605) 348-6500 |
| NPI Number | 1770873697 |
|---|---|
| Provider Enumeration Date | 04/12/2011 |
| Last Update Date | 04/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770873697 | NPI | - | NPPES |
| 6575750 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC-MH 2102 (South Dakota) | Primary |
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