Kambra Deitz, LCSW-PIP, RPT-S
Individual provider Active NPI Social Worker · Rapid City, SD
NPI 1447616552 · NPPES record last updated Dec 11, 2025
Key facts
- NPI
- 1447616552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 4931 (SD)
- Practice address
- 2138 Jackson Blvd
Rapid City, SD 57702-3495 - Phone
- (605) 718-0488
- NPI assigned
- Jan 5, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- University of North Dakota School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4698 S Placita Dos Pajaritos
Tucson, AZ 85730-5812
Phone (605) 718-0488
9095 E Tanque Verde Rd
Suite 171 PMB 167
Tucson, AZ 85749-8821
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200122002564 | SD | Practitioner - Clinical Social Worker | 2567733314 | Practice locations: Rapid City, SD |
| I20240416001955 | AZ | Practitioner - Mental Health Counselor | 2567733314 | Practice locations: Tucson, AZ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5062 | ND | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindfulness Matters Behavioral Health, LLC | Clinical | Current |
Accepting new patients |
Locations
2138 Jackson Blvd
Rapid City, SD 57702
Phone (605) 545-2814
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 5062 | ND | |
| Clinical Social Worker | 1041C0700X | 4931 | SD | |
| Clinical Social Worker | 1041C0700X | 5062 | ND | |
| Social Worker | 104100000X | 4931 | SD | Yes |
Addresses
Primary practice location
2138 Jackson Blvd
Rapid City, SD 57702-3495
Mailing address
4698 S Placita Dos Pajaritos
Tucson, AZ 85730-5812
Phone (605) 718-0488
Other practice location 1
10501 E Seven Generations Way Ste 201-10
Tucson, AZ 85747-5828
Phone (605) 718-0488
Other providers in Rapid City, SD
- Barry J. Degen
- Katherine Anne Degen
- Degryse Hearing Aid Center, Inc.
- Kelly A Degryse
- Matthew Robert Deichert
- Kayla Jo Dejong
- Sara Jo Dejong
- Limon Paul Del Rio
- David Delahoyde
- Donna Rae Delaney
All providers in Rapid City, SD · Social Worker in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.