BLACK HILLS CHILD PSYCHIATRIC SERVICES (NPI# 1861514416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861514416 |
| Entity Type | Organization |
| Organization Name | BLACK HILLS CHILD PSYCHIATRIC SERVICES |
| Other Organization Name | BLACK HILLS CHILD PSYCHIATRC SERVICES |
| Practice Address |
2920 Sheridan Lake Rd Rapid City SD 57702-5350 |
| Practice Telephone | 6057211991 |
| Practice Fax Number | 6053480479 |
| Mailing Telephone | 6057211991 |
| Mailing Fax Number | 6053480479 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-06-12 |
| Authorized Official Name | DR. SUSAN LYNN BUNNELL (OWNER) |
| Authorized Official Telephone | 6057211991 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
5576 | SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 7101880 | 05 |
| Other Name | Type Code |
|---|---|
| Black Hills Child Psychiatrc Services | Doing Business As Name - Organization |
| Street Address |
2920 SHERIDAN LAKE RD |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57702-5350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144303660 | Alan C Mccoy | Social Worker | 2920 Sheridan Lake Rd, Rapid City, SD 57702-5350 | 2006-10-21 |
| 1831709203 | Megan Laskowski | Counselor | 2920 Sheridan Lake Rd, Rapid City, SD 57702-5350 | 2020-07-31 |
| 1235622978 | Melisa Marie Good | Counselor | 2920 Sheridan Lake Rd, Rapid City, SD 57702-8191 | 2018-06-07 |
| 1326331927 | Rachel Dawn Shepherd | Social Worker | 2920 Sheridan Lake Rd, Rapid City, SD 57702-5350 | 2011-05-16 |
| 1366510141 | Duane J Kavanaugh | Counselor | 2920 Sheridan Lake Rd, Rapid City, SD 57702-5350 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049660 | Byrne Dental, Professional LLC | Dentist | 3825 Canyon Lake Dr, Rapid City, SD 57702 | 2020-10-08 |
| 1427603026 | Mikaela Licht | Technician | 4310 Cedar Ridge Pl. Apt #5, Rapid City, SD 57702 | 2019-08-09 |
| 1932761335 | Great Plains Tribal Chairmen's Health Board | Pharmacy | Oyate Health Center, 3200 Canyon Lake Drive, Rapid City, SD 57702 | 2019-07-05 |
| 1598231334 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702 | 2018-10-19 |
| 1851813224 | Angie Deneire | Licensed Practical Nurse | 7312 Pinon Jay Circle, Rapid City, SD 57702 | 2017-07-07 |
| 1073063830 | Kirsten William-kennedy Dds, Ms, P.C. | Dentist | 740 Sheridan Lk. Rd. Suite A, Rapid City, SD 57702 | 2016-10-05 |
| 1932558939 | Emily T Rausch | Physical Therapist | 2040 West Main, #212, Rapid City, SD 57702 | 2016-06-09 |
| 1033597810 | John Dennis Burke | Speech-Language Pathologist | 4635 Wentworth Drive, Rapid City, SD 57702 | 2015-05-12 |
| 1013394535 | Dakota Regional Periodontics | Dentist | 2800 Jackson Blvd #6, Rapid City, SD 57702 | 2015-05-05 |
| 1306272414 | Lindsy Jo Wathen | Speech-Language Pathologist | 13232 Klondike Road, Rapid City, SD 57702 | 2013-09-20 |
| Find all providers in zip 57702 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134779960 | Prairie Winds Counseling, LLC | Clinic/Center | 102 W 4th Ave Ste 1, Milbank, SD 57252-2400 | 2019-09-13 |
| 1912423500 | Visionary Mental Health Services | Clinic/Center | 108 W Missouri Ave, Pierre, SD 57501-4506 | 2017-08-16 |
| City | RAPID CITY |
| Zip Code | 57702 |
Please comment or provide details below to improve the information on BLACK HILLS CHILD PSYCHIATRIC SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.