Individual provider Active NPI

Jazmin Mendoza, MSW, LCSW

  • Clinical Social Worker
  • Rapid City, SD
National Provider Identifier
1134849243
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
909 Saint Joseph St Ste 201
Rapid City, SD 57701-3304
Phone
(605) 431-4151
Fax
(605) 431-4151
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 Primary

Addresses

Primary practice location

909 Saint Joseph St Ste 201
Rapid City, SD 57701-3304

Mailing address

528 Kansas City St Ste 3
Rapid City, SD 57701-5037
Phone (605) 299-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1914 Skerrols St
Fort Pierre, SD 57532-2390

420 S Henry St
Pierre, SD 57501-4515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid City Counseling Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

528 Kansas City St
Ste 5
Rapid City, SD 57701
Phone (605) 299-9100

909 Saint Joseph St
Ste 201
Rapid City, SD 57701
Phone (605) 209-9100

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1134849243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 KANSAS CITY ST STE 3",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015037",
            "telephone_number": "605-299-9100",
            "fax_number": "605-250-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SAINT JOSEPH ST STE 201",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013304",
            "telephone_number": "605-431-4151",
            "fax_number": "605-431-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "JAZMIN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.