Jennifer J. Kozel, PHD, LCP, Inc.
Organization Active NPI Clinical Psychologist · Rapid City, SD
NPI 1780950956 · NPPES record last updated Mar 31, 2012
Key facts
- NPI
- 1780950956
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 432 (SD)
- Legal business name
- JENNIFER J. KOZEL, PHD, LCP, INC.
- Practice address
- 1818 W Fulton St
Ste. 201
Rapid City, SD 57702-4377 - Phone
- (605) 348-6500
- Fax
- (605) 341-7409
- NPI assigned
- Mar 31, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Jennifer J. Kozel, PHD
- Title
- President
- Phone
- (605) 348-6500
Practitioners 1
-
Jenny Jane Kozel, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120727000420 | SD | Part B Supplier - Clinic/Group Practice | 8022274505 |
Receives reassigned benefits from 1 practitioner Practice locations: Rapid City, SD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 432 | SD | Yes |
Addresses
Primary practice location
1818 W Fulton St
Ste. 201
Rapid City, SD 57702-4377
Mailing address
1818 W Fulton St
Ste. 201
Rapid City, SD 57702-4377
Phone (605) 348-6500
Other providers in Rapid City, SD
- Kris Jeakins
- Anna Jealous of Him
- Jean Hoem Ms LPC-MH QMHP Inc
- Jeffrey Thomas Loftus DDS PC
- Jeffrey Wiswall DDS Ms PC
- Jennifer Jackson, LPC, PLLC
- Jennifer L.H. Friedman, DDS, PC
- Becky Jo Jenniges
- Abbie Jennings
- Loma Marie Jennings
All providers in Rapid City, 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 Mar 31, 2012. 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.