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2040 W Main St Ste 305 Rapid City SD 57702-2447 | |
| (605) 209-0446 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2040 W Main St Ste 305, Rapid City, South Dakota |
| Authorized Official Name and Position | Norma Pansch (OWNER) |
| Authorized Official Contact | 6052090446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 250 Rapid City SD 57709-0250 Ph: (605) 209-0446 | 2040 W Main St Ste 305 Rapid City SD 57702-2447 Ph: (605) 209-0446 |
| NPI Number | 1154990604 |
|---|---|
| Provider Enumeration Date | 06/20/2021 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 5294276093 |
|---|---|
| Medicare Enrollment ID | O20240919003933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154990604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Norma K Pansch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740749803 PECOS PAC ID: 2466993266 Enrollment ID: I20240919004025 |
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