Organization Active NPI

Human Service Agency

  • Addiction (Substance Use Disorder) Counselor
  • Watertown, SD
National Provider Identifier
1720074644
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
704 Issued in SD
Legal business name
HUMAN SERVICE AGENCY
Practice address
123 19TH St NE
Watertown, SD 57201-2823
Phone
(605) 886-0123
Fax
(605) 886-5447
NPI assigned
Sep 26, 2005
Last updated
Aug 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Dr. Kari Johnston, LPC-MHNPI 1538154554
Title
Ceo
Phone
(605) 886-0123

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 12

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 006 SD
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 704 SD Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 006 SD
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X 704 SD
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 006 SD
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X 704 SD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 006 SD
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 704 SD
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 006 SD
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 704 SD
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 006 SD
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 704 SD

Addresses

Primary practice location

123 19TH St NE
Watertown, SD 57201-2823

Mailing address

123 19TH St NE
Watertown, SD 57201-2823
Phone (605) 886-0123

Other identifiers 6

IdentifierTypeStateIssuer
5256010MedicaidSD
5255010MedicaidSD
0180020MedicaidSD
5200010MedicaidSD
5001040MedicaidSD
5261010MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000379 SD Part B Supplier - Clinic/Group Practice 3375447394 Receives reassigned benefits from 15 practitioners
Practice locations: Sisseton, SD; Watertown, SD

National Provider Directory

National Provider Directory

Locations

1303 E 4th Ave
Milbank, SD 57252
Phone (605) 432-4930

301 Veterans Ave
Sisseton, SD 57262
Phone (605) 698-7688

Practitioners & affiliated clinicians

Practitioners 92

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.

View all 92

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1720074644",
    "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": "605-886-5447"
        },
        {
            "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": "572012823",
            "telephone_number": "605-886-0123",
            "fax_number": "605-886-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-886-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC-MH"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "SD",
            "license": "006",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SD",
            "license": "704",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "SD",
            "license": "006",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "SD",
            "license": "704",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "006",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "SD",
            "license": "704",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "SD",
            "license": "006",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "SD",
            "license": "704",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "SD",
            "license": "006",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "SD",
            "license": "704",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "SD",
            "license": "006",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "SD",
            "license": "704",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5256010",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5255010",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180020",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200010",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5001040",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5261010",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.