Organization Active NPI

Practical Christian Counseling, Inc.

  • Mental Health Counselor
  • Rapid City, SD
National Provider Identifier
1376015123
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PRACTICAL CHRISTIAN COUNSELING, INC.
Practice address
1351 Jolly LN
Rapid City, SD 57703-4763
Phone
(605) 484-7089
NPI assigned
Dec 18, 2018
Last updated
Jun 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Authorized official

Name
Richard Scott Wiley, LPC-MH-SUPVNPI 1770944498
Title
Counselor/Owner
Phone
(605) 484-7089

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X 7059 SD
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1351 Jolly LN
Rapid City, SD 57703-4763

Mailing address

4951 Hansen LN
Rapid City, SD 57703-0147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240409003357 SD Part B Supplier - Clinic/Group Practice 2466890579 Receives reassigned benefits from 1 practitioner
Practice locations: Rapid City, SD

National Provider Directory

National Provider Directory

Locations

1351 Jolly Ln
Rapid City, SD 57703
Phone (605) 484-7089

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1376015123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 HANSEN LN",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577030147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 JOLLY LN",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577034763",
            "telephone_number": "605-484-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTICAL CHRISTIAN COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "COUNSELOR/OWNER",
        "authorized_official_telephone_number": "605-484-7089",
        "authorized_official_credential": "LPC-MH-SUPV"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SD",
            "license": "7059",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.