Jeff Konczak, MSW, PLCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PCSW-1148 Issued in WY

Practice address

500 N 5TH St
Hot Springs, SD 57747-1480

Phone

(605) 745-2000

NPI assigned

Sep 13, 2022

Last updated

Mar 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Southfield Mental Health Associates PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Southfield, MI
  • NPI 1619015872
  NPD (past)

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1942922430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7175 DUNSMORE RD APT 248",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577024504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 5TH ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471480",
            "telephone_number": "605-745-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONCZAK",
        "first_name": "JEFF",
        "credential": "MSW, PLCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "PCSW-1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Kearns, PHARMD
• Paula Jean Kennison, M.S.
• Debra Rose Keuten, MS, RD, LN
• Faith Kilby
• Kristeen Kirchgasler
• Suzanne Beth Kopp, PHARMD
• Kaushalya Ashok Kumar, MD
• Robert Lacharite, PHARMD
• John L Lane, RPH.
• Debrah Leatherman

• Clinical Social Worker in Hot Springs, SD
• Providers in Hot Springs, SD by specialty
• Clinical Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.