Kelley Backous

Individual provider Active NPI Mental Health Counselor · Huron, SD

NPI 1851823918 · NPPES record last updated Mar 29, 2017

Key facts

NPI
1851823918
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
357 Kansas Ave SE
Huron, SD 57350-2517
Phone
(605) 352-8596
Fax
(605) 352-7001
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Service Mental Health Past
since Apr 2, 2004
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

357 Kansas Ave SE
Huron, SD 57350-2517

Mailing address

357 Kansas Ave SE
Huron, SD 57350-2517
Phone (605) 352-8596

Other providers in Huron, SD

All providers in Huron, SD · Mental Health Counselor in South Dakota

Sources for this page

Verify at the official NPI Registry.