Dakota Southwestern Wellness, P. L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DAKOTA SOUTHWESTERN WELLNESS, P. L.L.C.

Practice address

606 4TH St SW
Bowman, ND 58623-4527

Phone

(701) 523-6985

Fax

(701) 279-7185

NPI assigned

Sep 16, 2016

Last updated

Sep 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Linda Kathryn Waller, LICSW, DCSW, LAC

Title

Authorized Official

Phone

(701) 279-6981

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1760930929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "BOWMAN",
            "state": "ND",
            "postal_code": "586230475",
            "telephone_number": "701-279-6981",
            "fax_number": "701-279-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 4TH ST SW",
            "city": "BOWMAN",
            "state": "ND",
            "postal_code": "586234527",
            "telephone_number": "701-523-6985",
            "fax_number": "701-279-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA SOUTHWESTERN WELLNESS, P. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "701-279-6981",
        "authorized_official_credential": "LICSW, DCSW, LAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bowman, ND
• Providers in Bowman, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.