Todd D Mack, CSW-PIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16095 Issued in MN

Practice address

123 19TH St NE
Watertown, SD 57201

Phone

(605) 886-0123

Fax

(605) 886-5447

NPI assigned

Nov 17, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/lsssd/r4/

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.

• Human Service Agency

  • Addiction (Substance Use Disorder) Counselor
  • Watertown, SD
  • NPI 1720074644
  NPD (past)
• Lutheran Social Services of South Dakota Inc

  • Voluntary or Charitable Agency
  • Sioux Falls, SD
  • NPI 1194885723
  NPD (past)

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1659608305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572012823",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "TODD",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "CSW-PIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Luoma
• Katerina Elise Lykins
• Salem N Maaliki, MD
• Emma R. Mack, D.C.
• Niccole J Mack, D.P.T.
• Brittany Elaine Macks
• Teresa Ann Madsen, CCSC II BS ALLIED
• Melissa J Magstadt, CNP
• Gertrude Boitumelo Makgabenyana, MA CLINICAL MENTAL
• Jered Marc Mancell, D.O.

• Clinical Social Worker in Watertown, SD
• Providers in Watertown, SD by specialty
• Clinical Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.