Lac Castor Wellness, LLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Rapid City, SD

NPI 1962858985 · NPPES record last updated Mar 20, 2017

Key facts

NPI
1962858985
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
CP001043 (SD)
Legal business name
LAC CASTOR WELLNESS, LLC
Practice address
3213 W Main St
Rapid City, SD 57702-2314
Phone
(605) 415-1616
NPI assigned
May 9, 2016
Organization subpart
No

Authorized official

Name
Dr. Melinda McCusker, PHD, CNP
Title
Owner/Founder
Phone
(605) 415-1616

National Provider Directory

Locations

3213 W Main St
Rapid City, SD 57702
Phone (402) 398-2282

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X CP001043 SD Yes

Addresses

Primary practice location

3213 W Main St
Rapid City, SD 57702-2314

Mailing address

3213 W Main St
Rapid City, SD 57702-2314
Phone (605) 415-1616

Other providers in Rapid City, SD

All providers in Rapid City, SD · Psychiatric/Mental Health Nurse Practitioner in South Dakota

Sources for this page

Verify at the official NPI Registry.