Firefly Counseling, LLC
Organization Active NPI Clinical Psychologist · Watertown, SD
NPI 1699346924 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1699346924
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- FIREFLY COUNSELING, LLC
- Practice address
- 2013 Willow Creek Dr Ste 2B
Watertown, SD 57201-9150 - Phone
- (605) 878-0376
- NPI assigned
- Jul 7, 2021
- Organization subpart
- No
Authorized official
- Name
- Katherine Hendricks, FNP-C
- Title
- Nurse Practitioner
- Phone
- (605) 237-3717
Practitioners 2
-
Lee Matthew Hendricks, PSY.D.
-
Kristina Cloutier, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211006002578 | SD | Part B Supplier - Clinic/Group Practice | 6709284672 |
Receives reassigned benefits from 1 practitioner Practice locations: Watertown, SD |
National Provider Directory
Locations
2013 Willow Creek Dr
Ste 2B
Watertown, SD 57201
Phone (605) 878-0376
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
2013 Willow Creek Dr Ste 2B
Watertown, SD 57201-9150
Mailing address
2028 Lanoue Cir
Watertown, SD 57201-5513
Phone (605) 237-3717
Other providers in Watertown, SD
- Eloise Joan Falk
- David Daniel Feist
- Michael S Fenster
- Kari Lynn Fieber
- Elliott W Filler
- Heather Fischer
- Carla R Fisher
- Bradley J Fishman
- Eric Fjeldheim
- Kari Jo E Fleming
All providers in Watertown, SD · Clinical Psychologist 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 1, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.