Individual provider Active NPI

Tamara Michelle Ulmer, LPC-MH QMHP

  • Clinical Social Worker
  • Rapid City, SD
National Provider Identifier
1376833368
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3413 Issued in SD
Practice address
2902 W Main St Ste 2
Rapid City, SD 57702-8174
Phone
(605) 721-8822
Fax
(605) 721-8822
NPI assigned
Apr 12, 2011
Last updated
Jul 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2232 SD
Clinical Social Worker 1041C0700X 3413 SD Primary

Addresses

Primary practice location

2902 W Main St Ste 2
Rapid City, SD 57702-8174

Mailing address

350 Elk St
Rapid City, SD 57701-7351
Phone (605) 343-7262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923001296 SD Practitioner - Clinical Social Worker 7012224033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scovel Psychological and Counseling Services LTDGroup PAC ID 2961493788, 9 clinicians

Practice addresses (Care Compare)

2902 W Main St
Suite 2
Rapid City, SD 57702-8174
Phone (605) 721-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2232SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scovel Psychological and Counseling Services, LTD CurrentSince Nov 10, 2018 Accepting new patients
Behavior Management Systems, Inc. PastSince Nov 13, 1990 Accepting new patients

Locations

2902 W Main St
Ste 2
Rapid City, SD 57702
Phone (605) 721-8822

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1376833368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ELK ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017351",
            "telephone_number": "605-343-7262",
            "fax_number": "605-343-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 W MAIN ST STE 2",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028174",
            "telephone_number": "605-721-8822",
            "fax_number": "605-721-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULMER",
        "first_name": "TAMARA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LPC-MH  QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "2232",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "3413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.