Shastin Gerbracht
Individual provider Active NPI Mental Health Counselor · Fort Meade, SD
NPI 1972963841 · NPPES record last updated Mar 26, 2024
Key facts
- NPI
- 1972963841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 113 Comanche Rd
Fort Meade, SD 57741-1002 - Phone
- (605) 720-6804
- NPI assigned
- Mar 4, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.0014897 | CO | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Community Provider Network Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC.0014897 | CO | |
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
113 Comanche Rd
Fort Meade, SD 57741-1002
Mailing address
4826 W Main St
Rapid City, SD 57702-1977
Phone (303) 241-3441
Other providers in Fort Meade, SD
- Amanda Gabrielson
- Heather Tayne Garreau
- Mark Alexander Gebbie
- Loni J Geffre
- Katherine Grace Gehrke
- Devon Geuke
- Lori Geuke
- Rhea Katharyn Go
- Steven K Goff
- Talona Gonzalez
All providers in Fort Meade, SD · Mental Health Counselor 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 Mar 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.