Individual provider Active NPI

Rebecca Jung, LCSW, QMHP

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1104423474
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6051 Issued in SD
Practice address
300 N Dakota Ave Ste 403
Sioux Falls, SD 57104-6032
Phone
(605) 409-3003
NPI assigned
Oct 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6051 SD Primary

Addresses

Primary practice location

300 N Dakota Ave Ste 403
Sioux Falls, SD 57104-6032

Mailing address

300 N Dakota Ave Ste 403
Sioux Falls, SD 57104-6032
Phone (605) 409-3003

Other names 1

  • Rebecca Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 6, 2024 through Mar 6, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6051SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jung Counseling, LLC Clinical Current Accepting new patients

Locations

300 N Dakota Ave
Ste 403
Sioux Falls, SD 57104
Phone (605) 409-3003

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1104423474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N DAKOTA AVE STE 403",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046032",
            "telephone_number": "605-409-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N DAKOTA AVE STE 403",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046032",
            "telephone_number": "605-409-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "REBECCA",
        "credential": "LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "6051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.