Black Hills Psychology, LLC
Organization Active NPI Clinical Psychologist · Spearfish, SD
NPI 1811290992 · NPPES record last updated Jan 20, 2026
Key facts
- NPI
- 1811290992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0000 (SD)
- Legal business name
- BLACK HILLS PSYCHOLOGY, LLC
- Practice address
- 115 N 7TH St Ste 6
Spearfish, SD 57783-2710 - Phone
- (605) 645-0100
- Fax
- (605) 717-1009
- NPI assigned
- Dec 13, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Shannon Jean Maxwell, PSY.D
- Title
- Owner, Authorized Official
- Phone
- (513) 304-4750
Practitioners 23
-
Brian Ruben Brandt, CNP, PMHNP-BC
-
Genaveve Hope Thomson, LCSW
-
Rebecca Mikel Tinsley, CNP, DNP, PMHNP
-
Erica Leigh Fett, LCSW-PIP
-
Emilia Sue Flint, PH.D.
-
Echo Lindsay Kopplin, DMSC, PA-C
-
Cherise Deann Lerew, PHD
-
Shannon Jean Maxwell, PSY.D, LP
-
Rita Larae Van Norman, LCSW
-
Mark Wesley Flint, LPC
-
Sonja Marie Halverson, LCSW
-
Kelli Powers, MT
-
Mandi Marie Scott, LPC
-
Travis Hugh Williamson, DNP, CNP, PMHNP-BC
-
Kimberly Ann Bahr, D.C.
-
Michele Marie Clodfelder, MS, LPC-MH
-
Tara Jean Ginter, LPC-MH
-
Jacob David Seidel, LPC-MH
-
Nancy Sprynczynatyk, LPC-MH
-
Melody Larsen, LMFT, LCPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101228000962 | SD | Part B Supplier - Clinic/Group Practice | 4587852009 |
Receives reassigned benefits from 10 practitioners Practice locations: Rapid City, SD; Spearfish, SD |
National Provider Directory
Locations
2525 W Main St
Ste 210
Rapid City, SD 57702
Phone (605) 399-2273
115 N 7th St
Ste 6
Spearfish, SD 57783
Phone (605) 645-0100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | SD | ||
| Professional Counselor |
101YP2500X | 000000 | SD | |
| Clinical Psychologist |
103TC0700X | 0000 | SD | Yes |
| Counseling Psychologist |
103TC1900X | SD | ||
| Clinical Child & Adolescent Psychologist |
103TC2200X | 0000 | SD | |
| Clinical Social Worker |
1041C0700X | 0000 | SD | |
| Psychiatry Physician |
2084P0800X | |||
| Child & Adolescent Psychiatry Physician |
2084P0804X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | SD |
Addresses
Primary practice location
115 N 7TH St Ste 6
Spearfish, SD 57783-2710
Mailing address
115 N 7TH St Ste 6
Spearfish, SD 57783-2710
Phone (605) 645-0100
Other practice location 1
2525 W Main St Ste 210
Rapid City, SD 57702-2439
Phone (605) 645-0100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2001655 | Medicaid | SD |
Other providers in Spearfish, SD
- Morgan Bialas
- Katherine M Bifulco
- Krista Bree Birkelo
- Black Hills Dermatology PC
- Black Hills Physical Therapy, Inc.
- Black Hills Surgical Hospital, LLP
- Black Hills Transit Inc
- Jessica Mae Blankenship
- William Harold Blauer
- Bob'S Pharmacy, Inc.
All providers in Spearfish, 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 Jan 20, 2026. 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.