| Slate Creek Counseling Pc | |
|
319 Coteau St Pierre SD 57501-3187 | |
| (605) 220-1093 | |
| Not Available |
| Full Name | Slate Creek Counseling Pc |
|---|---|
| Speciality | Counselor |
| Location | 319 Coteau St, Pierre, South Dakota |
| Authorized Official Name and Position | Jonathan Rapp (PRESIDENT) |
| Authorized Official Contact | 6054849679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Slate Creek Counseling Pc Po Box 412 Pierre SD 57501-0412 Ph: (605) 220-1093 | Slate Creek Counseling Pc 319 Coteau St Pierre SD 57501-3187 Ph: (605) 220-1093 |
| NPI Number | 1104950195 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 12/03/2021 |
| Certification Date | 12/03/2021 |
| Medicare PECOS PAC ID | 0648685768 |
|---|---|
| Medicare Enrollment ID | O20211018000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104950195 | NPI | - | NPPES |
| 6571170 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Jonathan Rapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477687804 PECOS PAC ID: 3375615289 Enrollment ID: I20080710000169 |
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