The Wellness Collective | |
2333 W 57th St Ste 103 Sioux Falls SD 57108-5054 | |
(605) 271-5640 | |
Not Available |
Full Name | The Wellness Collective |
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Speciality | Social Worker |
Location | 2333 W 57th St Ste 103, Sioux Falls, South Dakota |
Authorized Official Name and Position | Amanda Briggs Davis (OWNER) |
Authorized Official Contact | 6052715640 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Wellness Collective 2333 W 57th St Ste 103 Sioux Falls SD 57108-5054 Ph: (605) 271-5640 | The Wellness Collective 2333 W 57th St Ste 103 Sioux Falls SD 57108-5054 Ph: (605) 271-5640 |
NPI Number | 1679195580 |
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Provider Enumeration Date | 05/13/2020 |
Last Update Date | 10/03/2020 |
Certification Date | 10/03/2020 |
Medicare PECOS PAC ID | 1951722834 |
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Medicare Enrollment ID | O20200601002419 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679195580 | NPI | - | NPPES |
1922396027 | Medicaid | SD | |
S50694 | Other | SD | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Amanda B Davis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1922396027 PECOS PAC ID: 6800069600 Enrollment ID: I20111021000411 |
Provider Name | Mallory R Hogan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487139374 PECOS PAC ID: 1557603982 Enrollment ID: I20190503001261 |
Provider Name | Tegan A Mcmanaman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619639408 PECOS PAC ID: 1759772957 Enrollment ID: I20211223000365 |
Provider Name | Shjade Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710696919 PECOS PAC ID: 8921457706 Enrollment ID: I20231206001724 |
Provider Name | Derek Granum |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1982259230 PECOS PAC ID: 6507198595 Enrollment ID: I20240109002929 |
Provider Name | Cristina Elisa Buus |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1164949442 PECOS PAC ID: 1951747328 Enrollment ID: I20240307001623 |
Provider Name | Lauren Casey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073206884 PECOS PAC ID: 5294175683 Enrollment ID: I20240502001231 |
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