Latonya C.M. Gage

Individual provider Active NPI Clinical Social Worker · Aberdeen, SD

NPI 1972016277 · NPPES record last updated Aug 17, 2021

Key facts

NPI
1972016277
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
5240 (SD)
Practice address
14 S Main St Ste 1E
Aberdeen, SD 57401-4189
Phone
(605) 225-1010
Fax
(605) 725-8055
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5240SDMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4755 SD
Clinical Social Worker 1041C0700X 5240 SD Yes

Addresses

Primary practice location

14 S Main St Ste 1E
Aberdeen, SD 57401-4189

Mailing address

14 S Main St Ste 1E
Aberdeen, SD 57401-4189
Phone (605) 225-1010

Other providers in Aberdeen, SD

All providers in Aberdeen, SD · Clinical Social Worker in South Dakota

Sources for this page

Verify at the official NPI Registry.