Individual and Family Counseling

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-MH2002 Issued in SD

Legal business name

INDIVIDUAL AND FAMILY COUNSELING

Practice address

2650 Jackson Blvd # 198
Rapid City, SD 57702-3474

Phone

(605) 484-5294

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

James Simpson

Title

Provider

Phone

(605) 484-5294

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1184151946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 JACKSON BLVD # 198",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577023474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 JACKSON BLVD # 198",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577023474",
            "telephone_number": "605-484-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL AND FAMILY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "605-484-5294"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC-MH2002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902886658",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.